Risk Factors for Gestational Diabetes Mellitus(GDM)in Subsequent Pregnancy Among Women Without GDM History in China:A Multicenter Retrospective Study

Objective:This study aimed to determine the likelihood of gestational diabetes mellitus(GDM)in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy.Methods:This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018.Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further.Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy,and the characteristics and GDM risk of these groups were compared.A univariate analysis of potential risk factors was performed using the Chi-squared test and/ort-test for qualitative or quantitative variables,respectively.Associations withP values<0.1 were chosen to be included in the multivariate binary logistic regression model.Results:In primary analysis of 6204 women,the incidence of GDM in subsequent pregnancy is 48.9%(490/1002)in women with GDM history and 16.1%(835/5202)in women without GDM history.In a further analysis for 5180 women without GDM at index pregnancy,compared with the non-GDM group,the GDM group had a significantly higher age,prepregnancy body mass index,and blood glucose value at each oral glucose tolerance test(OGTT)timepoint(fasting,1 h and 2 h)during the index and subsequent pregnancies,as well as higher weight retention during the interval between the two pregnancies(P<0.001).Age above 35 years in subsequent pregnancy(odds ratio(OR)=1.540,95%confidence interval(CI)=1.257-1.886,P<0.001),macrosomia in index pregnancy(OR=1.749,95%CI=1.277-2.395,P=0.001),OGTT blood glucose values in index pregnancy(fasting,OR=2.487,95%CI=1.883-3.285,P<0.001;1 h,OR=1.142,95%CI=1.051-1.241,P=0.002;2 h,OR=1.290,95%CI=1.162-1.432,P<0.001)and weight retention(OR=1.052,95%CI=1.035-1.068,P<0.001)were independent risk factors for GDM in subsequent pregnancy.Conclusion:For women without GDM history,GDM risk factors including age,macrosomia history,OGTT value,and weight retention,these can be evaluated before a subsequent pregnancy.Early warning and interventions are needed for women at high risk.

Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community

BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.

Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance

BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic disease featured by insulin resistance(IR)and decreased insulin secretion.Currently,vitamin D deficiency is found in most patients with T2DM,but the relationship between vitamin D and IR in T2DM patients requires further investigation.AIM To explore the risk factors of IR and the effects of vitamin D supplementation on glucose and lipid metabolism in patients with T2DM.METHODS Clinical data of 162 T2DM patients treated in First Affiliated Hospital of Harbin Medical University between January 2019 and February 2022 were retrospectively analyzed.Based on the diagnostic criteria of IR,the patients were divided into a resistance group(n=100)and a non-resistance group(n=62).Subsequently,patients in the resistance group were subdivided to a conventional group(n=44)or a joint group(n=56)according to the treatment regimens.Logistic regression was carried out to analyze the risk factors of IR in T2DM patients.The changes in glucose and lipid metabolism indexes in T2DM patients with vitamin D deficiency were evaluated after the treatment.RESULTS Notable differences were observed in age and body mass index(BMI)between the resistance group and the non-resistance group(both P<0.05).The resistance group exhibited a lower 25-hydroxyvitamin D_(3)(25(OH)D_(3))level,as well as notably higher levels of 2-h postprandial blood glucose(2hPG),fasting blood glucose(FBG),and glycosylated hemoglobin(HbA1c)than the non-resistance group(all P<0.0001).Additionally,the resistance group demonstrated a higher triglyceride(TG)level but a lower high-density lipoprotein-cholesterol(HDL-C)level than the non-resistance group(all P<0.0001).The BMI,TG,HDL-C,25(OH)D_(3),2hPG,and HbA1c were found to be risk factors of IR.Moreover,the posttreatment changes in levels of 25(OH)D_(3),2hPG,FBG and HbA1c,as well as TG,total cholesterol,and HDL-C in the joint group were more significant than those in the conventional group(all P<0.05).CONCLUSION Patients with IR exhibit significant abnormalities in glucose and lipid metabolism parameters compared to the noninsulin resistant group.Logistic regression analysis revealed that 25(OH)D_(3)is an independent risk factor influencing IR.Supplementation of vitamin D has been shown to improve glucose and lipid metabolism in patients with IR and T2DM.

Establishment and evaluation of a risk prediction model for gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a condition characterized by high blood sugar levels during pregnancy.The prevalence of GDM is on the rise globally,and this trend is particularly evident in China,which has emerged as a significant issue impacting the well-being of expectant mothers and their fetuses.Identifying and addressing GDM in a timely manner is crucial for maintaining the health of both expectant mothers and their developing fetuses.Therefore,this study aims to establish a risk prediction model for GDM and explore the effects of serum ferritin,blood glucose,and body mass index(BMI)on the occurrence of GDM.AIM To develop a risk prediction model to analyze factors leading to GDM,and evaluate its efficiency for early prevention.METHODS The clinical data of 406 pregnant women who underwent routine prenatal examination in Fujian Maternity and Child Health Hospital from April 2020 to December 2022 were retrospectively analyzed.According to whether GDM occurred,they were divided into two groups to analyze the related factors affecting GDM.Then,according to the weight of the relevant risk factors,the training set and the verification set were divided at a ratio of 7:3.Subsequently,a risk prediction model was established using logistic regression and random forest models,and the model was evaluated and verified.RESULTS Pre-pregnancy BMI,previous history of GDM or macrosomia,hypertension,hemoglobin(Hb)level,triglyceride level,family history of diabetes,serum ferritin,and fasting blood glucose levels during early pregnancy were determined.These factors were found to have a significant impact on the development of GDM(P<0.05).According to the nomogram model’s prediction of GDM in pregnancy,the area under the curve(AUC)was determined to be 0.883[95%confidence interval(CI):0.846-0.921],and the sensitivity and specificity were 74.1%and 87.6%,respectively.The top five variables in the random forest model for predicting the occurrence of GDM were serum ferritin,fasting blood glucose in early pregnancy,pre-pregnancy BMI,Hb level and triglyceride level.The random forest model achieved an AUC of 0.950(95%CI:0.927-0.973),the sensitivity was 84.8%,and the specificity was 91.4%.The Delong test showed that the AUC value of the random forest model was higher than that of the decision tree model(P<0.05).CONCLUSION The random forest model is superior to the nomogram model in predicting the risk of GDM.This method is helpful for early diagnosis and appropriate intervention of GDM.

Risk factors of concurrent urinary sepsis in patients with diabetes mellitus comorbid with upper urinary tract calculi

BACKGROUND Urinary sepsis is frequently seen in patients with diabetes mellitus(DM)complicated with upper urinary tract calculi(UUTCs).Currently,the known risk factors of urinary sepsis are not uniform.AIM To analyze the risk factors of concurrent urinary sepsis in patients with DM complicated with UUTCs by logistic regression.METHODS We retrospectively analyzed 384 patients with DM complicated with UUTCs treated in People’s Hospital of Jincheng between February 2018 and May 2022.The patients were screened according to the inclusion and exclusion criteria,and 204 patients were enrolled.The patients were assigned to an occurrence group(n=78)and a nonoccurrence group(n=126).Logistic regression was adopted to analyze the risk factors for urinary sepsis,and a risk prediction model was established.RESULTS Gender,age,history of lumbago and abdominal pain,operation time,urine leukocytes(U-LEU)and urine glucose(U-GLU)were independent risk factors for patients with concurrent urinary sepsis(P<0.05).Risk score=0.794×gender+0.941×age+0.901×history of lumbago and abdominal pain-1.071×operation time+1.972×U-LEU+1.541×U-GLU.The occurrence group had notably higher risk scores than the nonoccurrence group(P<0.0001).The area under the curve of risk score for forecasting concurrent urinary sepsis in patients was 0.801,with specificity of 73.07%,sensitivity of 79.36%and Youden index of 52.44%.CONCLUSION Sex,age,history of lumbar and abdominal pain,operation time,ULEU and UGLU are independent risk factors for urogenic sepsis in diabetic patients with UUTC.

Prevalence, Risk Factors, and Awareness of Chronic Kidney Disease among Diabetes Mellitus and Hypertensive Individuals at the Buea Regional Hospital, Cameroon

Background: Kidney failure, cardiovascular disease, and early mortality are just a few of the major negative effects of chronic renal disease, a serious global health issue. The considerable financial and public health burden associated with chronic kidney disease can be lessened by raising awareness and adopting better practices for its impact, prevention, and early identification. Objective: In this study, individuals with hypertension and diabetes were evaluated for their knowledge of chronic kidney disease, its prevalence, and its risk factors. Method: It was a hospital-based cross-sectional study conducted on adult (>18 years) patients with diabetes mellitus and hypertension. Each participant provided written informed consent before having their data collected through interviews, medical information, and blood samples for CKD screening. The CKD epidemiology collaboration (CKD-EPI) equation was used to calculate the glomerular filtration rate (GFR) from serum creatinine, and CKD was determined using the estimated GFR (e-GFR). To find independent CKD factors, multivariate logistic regression was employed, with a p-value of 0.05 being regarded as statistically significant. This was accomplished using SPSS (Statistical Program for Social Sciences) version 22.0, IBM Corp., Armonk, NY. Result: A total of 156 participants took part in the study among which 95 (60.9%) were male, most of the participants 82 (52.6%) were aged between 51 - 70 years (mean 59.42 ± 11.007), 76 (48.7%) were unemployed and 97 (62.2%) were single. Overall, the knowledge score of participants on CKD was 65.4% for good knowledge and 34.6% for poor or inadequate knowledge of CKD. More than half of the participants (60%) had chronic kidney disease. Among these, the greatest proportion of CKD patients were those who were hypertensive (88.2%) followed by those who were both hypertensive and diabetic (70.7%). Conclusion: There is poor management of CKD in the South West Region of Cameroon which has contributed greatly to the progression of CKD and increases in the mortality rate.

Risk factors for new onset diabetes mellitus after liver transplantation: A meta-analysis

AIM: To determine the risk factors for new-onset diabetes mellitus(NODM) after liver transplantation by conducting a systematic review and meta-analysis.METHODS: We electronically searched the databases of MEDLINE, EMBASE and the Cochrane Library from January 1980 to December 2013 to identify relevant studies reporting risk factors for NODM after liver transplantation. Two authors independently assessed the trials for inclusion and extracted the data. Discrepancies were resolved in consultation with a third reviewer. All statistical analyses were performed with the Rev Man5.0 software(The Cochrane Collaboration, Oxford, United Kingdom). Pooled odds ratios(OR) or weighted mean differences(WMD) with 95% confidence intervals(CIs) were calculated using either a fixed effects or a random effects model, based on the presence(I2 < 50%) or absence(I2 > 50%) of significant heterogeneity. RESULTS: Twenty studies with 4580 patients were included in the meta-analysis, all of which were retrospective. The meta-analysis identified the following significant risk factors: hepatitis C virus(HCV) infection(OR = 2.68; 95%CI: 1.92-3.72); a family history of diabetes(OR = 1.69, 95%CI: 1.09-2.63, P < 0.00001); male gender(OR = 1.53; 95%CI: 1.24-1.90; P < 0.0001); impaired fasting glucose(IFG; OR = 3.27; 95%CI: 1.84-5.81; P < 0.0001); a family history of diabetes(OR = 1.69; 95%CI: 1.09-2.63; P = 0.02); use of tacrolimus(OR = 1.34; 95%CI: 1.03-1.76; P = 0.03) and body mass index(BMI)(WMD = 1.19, 95%CI: 0.69-1.68, P < 0.00001). Other factors, such as hepatitis B virus infection and alcoholism, were not found to be associated with the incidence of NODM.CONCLUSION: The study showed that HCV infection, IFG, a family history of diabetes, male gender, tacrolimus and BMI are risk factors for NODM after liver transplantation.

Risk factors for diabetic retinopathy in northern Chinese patients with type 2 diabetes mellitus

AIM: To investigate the prevalence and risk factors of diabetic retinopathy(DR) in northern Chinese patients with type 2 diabetes mellitus(T2DM).METHODS: This retrospective cross-sectional study was performed between May 2011 and April 2012. A total of 1100 patients(male/female, 483/617) were included in this study. DR was defined following the Early Treatment Diabetic Retinopathy Study(ETDRS) severity scale. All included patients accepted a comprehensive ophthalmic examination including retinal photographs. Logistic regression models were used to estimate odds ratios(ORs) and 95% confidence interval(CI) after adjusting for age and gender.RESULTS: Retinopathy was present in 307 patients with a prevalence of 27.9%. In univariate logistic analysis,presence of DR was associated with longer duration of diabetes(OR, 5.70; 95% CI, 2.91-12.56), higher concentration of fasting blood glucose(OR, 12.94; 95%CI, 2.40-67.71), higher level of glycosylated hemoglobin Hb A1c(OR, 5.50; 95% CI, 3.78-11.97) and insulin treatment(OR, 6.99; 95% CI, 1.39-35.12). The lifestyle of patients with T2DM including smoking, alcohol consumption and regular exercise seemed not associated with the development of DR.CONCLUSION: Our study suggests that fasting serum glucose concentration, Hb A1 c level, duration of diabetes and insulin treatment are potential risk factors for DR in northern Chinese patients with T2DM, while the lifestyle of included patients seems not associated with DR.

Gestational Diabetes Mellitus and Its Associated Risk Factors in Pregnant Women at Selected Health Facilities in Kigali City, Rwanda

Background: Gestational Diabetes Mellitus (GDM) is the most common complication of pregnancy that causes chronic hypertension, increased rate of cesarean delivery, fetal mortality and morbidity. Therefore, early diagnosis of GDM is vital to reduce maternal and fetal morbidity. Moreover, it can circumvent or procrastinate the onset of type 2 diabetes. Objectives: The main objective of this study was to determine the prevalence of GDM in pregnant women attending Kimironko, Kicukiro and Muhima Health Centres. The specific objectives were to determine the blood glucose during the second trimester in pregnant women aged between 21 and 45 years, to find out the frequencies of pregnant women presenting with GDM according to age and to assess some promising risk factors associated with GDM. Methods: A cross-sectional study was carried out at Kimironko, Kicukiro and Muhima Health centers using a sample size of 96 pregnant women. Blood glucose levels were measured using glucose oxidase method with a glucometer. Data were analyzed by using Microsoft Office Excel and SPSS version 20. Results: Out of 96 pregnant women who participated in the study, 8.3% were found to have GDM with the mean ± 2SD of 194.12 ± 25.53 mg/dl of their blood glucose results (Mean ± 2SD: A 95% level of confidence Intervals). The highest proportion of GDM was revealed in pregnant women aged between 26 - 30 years, representing a frequency of 5.2% whereas 2.1% of GDM was reflected in women aged between 21 - 25 years. The lowest proportion of GDM fell in age group of 31 - 35 years contributing to 1% of the total GDM. There were no cases of GDM in pregnant women in the 36 - 40 or 41 - 45 age groups. The mean ± 2SD of participant’s age groups was 27.12 ± 5.01 years. In addition, while obesity did not show to be associated with GDM, age and family history were found to be risk factors of GDM. Conclusion: The findings of this study revealed that the prevalence of GDM was 8.3% and the most affected pregnant women were in the age group of 26 - 30 years.

Prevalence, risk factors, and BRAF mutation of colorectal sessile serrated lesions among Vietnamese patients

BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma pathway,with limited data on the serrated pathway.AIM To evaluate the prevalence,risk factors,and BRAF mutations of SSLs in the Vietnamese population.METHODS This is a cross-sectional study conducted on patients with lower gastrointestinal symptoms who underwent colonoscopy at a tertiary hospital in Vietnam.SSLs were diagnosed on histopathology according to the 2019 World Health Organi-zation classification.BRAF mutation analysis was performed using the Sanger DNA sequencing method.The multivariate logistic regression model was used to determine SSL-associated factors.RESULTS There were 2489 patients,with a mean age of 52.1±13.1 and a female-to-male ratio of 1:1.1.The prevalence of SSLs was 4.2%[95%confidence interval(CI):3.5-5.1].In the multivariate analysis,factors significantly associated with SSLs were age≥40[odds ratio(OR):3.303;95%CI:1.607-6.790],male sex(OR:2.032;95%CI:1.204-3.429),diabetes mellitus(OR:2.721;95%CI:1.551-4.772),and hypertension(OR:1.650,95%CI:1.045-2.605).The rate of BRAF mutations in SSLs was 35.5%.CONCLUSION The prevalence of SSLs was 4.2%.BRAF mutations were present in one-third of SSLs.Significant risk factors for SSLs included age≥40,male sex,diabetes mellitus,and hypertension.

Diabetes mellitus and prostate cancer risk:A mendelian randomization analysis

BACKGROUND Some studies have directed towards an association between diabetes mellitus(DM)and prostate cancer(PCa);however,this specific relationship remains inconclusive.In recent years,Mendelian randomization(MR)has become a widely used analytical method for inferring epidemiological causes.AIM To investigated the potential relationship between DM and PCa using MR.METHODS We downloaded relevant data on"diabetes"and"PCa"from the IEU OpenGWAS project database,performed three different methods to conduct MR,and carried out sensitivity analysis for verification.RESULTS The results indicated that DM was an independent risk factor for PCa.The odds ratio(OR)values obtained using the inverse variance weighted method in this study were as follows:OR=1.018(95%confidence interval:1.004-1.032),P=0.014.CONCLUSION We found that DM could increase the incidence rate of PCa.

Diabetes mellitus: a “true” independent risk factor for hepatocellular carcinoma?

BACKGROUND:Diabetes mellitus(DM)is thought to be associated with an increased risk of hepatocellular carcinoma(HCC)in some published studies.However,can we draw the conclusion that DM is a"true"independent risk factor for HCC based on these references? DATA SOURCES:MEDLINE and PubMed searches were conducted for published studies(between January 1966 and June 2009)to identify relevant articles using the keywords "diabetes","insulin resistance"and"hepatocellular carcinoma",including"primary liver cancer".Because of the very limited number of relevant articles most were reviewed. RESULTS:This systematic review was conducted from 4 aspects:(1)the significant synergy between DM,hepatitis virus infection,and heavy alcohol consumption in HCC; (2)the role of DM independently in HCC cases while other identified risk factors were controlled or excluded; (3)obesity,DM,and nonalcoholic fatty liver disease in HCC patients;and(4)the impact of DM for the prognosis or surgical treatment in HCC patients with DM.No consensus has been reached among these studies and it is too early to draw the conclusion that DM is a"true" independent risk factor for HCC. CONCLUSIONS:DM can be regarded as a risk factor for HCC.However,whether DM itself directly predisposes to HCC or whether it is a"true"independent risk factor remains unclear.Related issues should be clarified by more research.

Epidemiological characteristics and risk factors of diabetic retinopathy in type 2 diabetes mellitus in Shandong Peninsula of China

·AIM:To determine the epidemiological characteristics and estimate the risk factors of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) in Shandong Peninsula of China.·METHODS:The cases of T2DM admitted to Affiliated Hospital of Medical College of Qingdao University,Shandong Province,China,from January 2006 to December 2010 were retrospectively reviewed.The epidemiological characteristics of DR were estimated.The cases were divided into two groups according to degrees of retinopathy:non-DR group and DR group.Logistic regression analysis was used to study the related risk factors of DR.·RESULTS:The prevalence of DR in patients with T2DM was 25.08% (834/3326).There was significant difference between the average age for men (59.08?à15.43 years) and for women (62.92?à18.19 years,P =0.0021).The majority of DR occurred in women (female:male ratio=1.76:1,P <0.0001).The incidence rate of DR in urban (489/834) was higher than that in rural area (345/834,P <0.0001).In 834 DR patients,the mean duration of T2DM was 8.90?à4.15 years (range:0-16 years);440 people (52.76%) had received varying degrees of health education about prevention and primary care of DM;and 473 people (56.71%) suffered from other DM complications confirmed at the same time.In addition,the incidence rate of monocular (551/3326) and binocular retinopathy (283/3326) were statistically different (P<0.0001).Factors associated (P<0.05) with the presence of DR included old age,lower health educational level,intraocular surgery history,longer duration of T2DM,accompanying with other DM complications,no standard treatment procedure,lower body mass index (BMI) and higher fasting plasma glucose (FPG),glycated hemoglobin A1C (HbA1C),urine albumin (UA),total cholesterol (TC),low-density-lipoprotein cholesterol (LDL-C).The risk factors (P <0.05) independently associated with the presence of DR were:longer duration of T2DM,lower health educational level,higher FPG,higher UA,lower BMI and higher TC.·CONCLUSION:DR is highly prevalent in the patients with T2DM in Shandong Peninsula of China.Besides blood glucose,many factors are associated with the present and development of DR.·

Is diabetes mellitus a risk factor for pancreatic cancer?

The relationship between diabetes mellitus and the risk of pancreatic cancer has been a matter of study for a long period of time.The importance of this topic is due to two main causes:the possible use of recent onset diabetes as a marker of the disease and,in particular,as a specific marker of pancreatic cancer,and the selection of a population at risk for pancreatic cancer.Thus,we decided to make an in-depth study of this topic;thus,we carried out an extensive literature search in order to re-assess the current knowledge on this topic.Even if diabetes is found a decade before the appearance of pancreatic cancer as reported in meta-analytic studies,we cannot select those patients already having non detectable pancreatic cancer,at least with the imaging and biological techniques available today.We believe that more studies are necessary in order to definitively identify diabetes mellitus as a risk factor for pancreatic cancer taking into consideration that approximately 10 years are needed to diagnose symptomatic pancreatic cancer.At present,the answer to the as to whether diabetes and pancreatic cancer comes first similar to the adage of the chicken and the egg is that diabetes is the egg.

Diabetes mellitus increases risk for colorectal adenomas in younger patients

AIM:To determine if diabetes mellitus(DM)is associated with increased risk of colorectal adenomas in younger subjects.METHODS:This was a retrospective cohort study of375 patients undergoing index colonoscopy at a single tertiary care center in the United States.Three cohorts of patients matched for exam date and gender were compared:(1)ages 40-49 years with DM;(2)ages40-49 years without DM;and(3)ages 50-59 years without DM.Data collected included demographics,co-morbidities,colonoscopy and pathology results.Adenoma detection rates(ADR)were calculated and compared.Conditional logistic regression analysis was performed to determine the association between each cohort and ADR.RESULTS:One hundred and twenty-five patients ages40-49 with DM met study eligibility criteria.Patients in the other two cohorts were randomly selected,match-ing for date of exam and gender.ADR was 14.4%in those ages 40-49 years without DM,30.4%in those ages 40-49 years with DM,and 32.0%in those ages50-59 years without DM.Compared to those ages40-49 years without DM,ADR was higher in those ages40-49 years with DM(OR=3.1;95%CI:1.5-6.4;P=0.002)and those ages 50-59 years without DM(OR=2.9;95%CI:1.5-5.6;P=0.002).There was no difference between the ADR in those ages 40-49 years with DM and those ages 50-59 years without DM(P=0.83).CONCLUSION:DM was associated with higher risk of colorectal adenomas in patients ages 40-49 years.These subjects harbored as many adenomas as those at the standard screening age of 50-59 years without DM.

Prediction of Gestational Diabetes Mellitus in Early Pregnancy: Is Abdominal Skin Fold Thickness 20 mm or More an Independent Risk Predictor?

Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, risk factors and predictors of GDM in early pregnancy at the University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria. Methods: A cohort of 235 mothers who registered for antenatal care between 15 - 18 weeks of gestation at UPTH was prospectively studied. Their socio-demographic data, examination findings, anthropometric measurements, fasting blood sugar at booking and OGTT results at 28 weeks gestation were collated and entered into PC with SPSS for windows version 21.0 which was also used for the analysis. Variables were expressed as absolute numbers, percentages or means with standard deviations and significant differences determined using chi square test or the student “t” test as appropriate. The level of significance was set at P < 0.05. Results: Of the 235 participants, 35 (14.9%) developed GDM. Women who had GDM were significantly older (P = 0.001), had higher weight (t = 2.95, P = 0.01), BMI (t = 2.29, P = 0.02), abdominal skin fold thickness (t = 4.15, P = 0.001), blood pressure (t = 3.38, P = 0.001) compared to women who did not. Previous history of GDM was significantly different between two groups as χ2 = 93.56 and P = 0.001. Abdominal skin fold thickness and prior GDM history were found to be independent predictors of GDM on application of multiple logistic regression analysis. Conclusion: The prevalence of GDM in Port Harcourt is 14.9% and major risk factors are obesity, previous GDM history, advanced age and hypertension. Abdominal skin fold thickness ≥ 20 mm is an independent predictor. The risk of developing GDM can be predicted in early second trimester using algorithm incorporating risk factor screening and anterior abdominal wall skin fold thickness estimation.

Holistic Evaluation of the Morbidity Due to Diabetes Mellitus Type 2 and Its Main Risk Factors in the State of San Luis Potosi, Mexico

Objective: To evaluate the morbidity due to diabetes mellitus type 2 within the State of San Luis Potosí, México, through a strong methodology, through which the multivariate relations were identified of the main social and environmental determiners in the disease, thus managing to quantify their respective levels of responsibility. Material and Methods: This evaluation began as a hypothesis of a multicasual theoretical model on diabetes mellitus and its main determining factors, which was analyzed through the application of multivariate exploratory statistical methodologies and confirmed as it is the case of the principal components analysis and the structural equation models. Results: Three components were extracted that explain the 96% of the total variance of the indicators;the main risk factors which were identified in the first component were, the use of the car, age, homes with TV use, urban life and feminine population;the indicators from the second and third component have little influence in the impact of the disease. Conclusions: the study shows the usefulness of the model for the analysis and prioritization of the environmental and social determiners of the disease, information that could sustain the design of public guidelines for the prevention and control of the analyzed disease.

Risk factors for mortality within 6 mo in patients with diabetes undergoing urgent-start peritoneal dialysis:A multicenter retrospective cohort study

BACKGROUND The risk of early mortality of patients who start dialysis urgently is high;however,in patients with diabetes undergoing urgent-start peritoneal dialysis(USPD),the risk of,and risk factors for,early mortality are unknown.AIM To identify risk factors for mortality during high-risk periods in patients with diabetes undergoing USPD.METHODS This retrospective cohort study enrolled 568 patients with diabetes,aged≥18 years,who underwent USPD at one of five Chinese centers between 2013 and 2019.We divided the follow-up period into two survival phases:The first 6 mo of USPD therapy and the months thereafter.We compared demographic and baseline clinical data of living and deceased patients during each period.Kaplan-Meier survival curves were generated for all-cause mortality according to the New York Heart Association(NYHA)classification.A multivariate Cox proportional hazard regression model was used to identify risk factors for mortality within the first 6 mo and after 6 mo of USPD.RESULTS Forty-one patients died within the first 6 mo,accounting for the highest proportion of mortalities(26.62%)during the entire follow-up period.Cardiovascular disease was the leading cause of mortality within 6 mo(26.83%)and after 6 mo(31.86%).The risk of mortality not only within the first 6 mo but also after the first 6 mo was higher for patients with obvious baseline heart failure symptoms than for those with mild or no heart failure symptoms.Independent risk factors for mortality within the first 6 mo were advanced age hazard ratio(HR:1.908;95%CI:1.400-2.600;P<0.001),lower baseline serum creatinine level(HR:0.727;95%CI:0.614-0.860;P<0.001),higher baseline serum phosphorus level(HR:3.162;95%CI:1.848-5.409;P<0.001),and baseline NYHA class III-IV(HR:2.148;95%CI:1.063-4.340;P=0.033).Independent risk factors for mortality after 6 mo were advanced age(HR:1.246;95%CI:1.033-1.504;P=0.022)and baseline NYHA class III-IV(HR:2.015;95%CI:1.298-3.130;P=0.002).CONCLUSION To reduce the risk of mortality within the first 6 mo of USPD in patients with diabetes,controlling the serum phosphorus level and improving cardiac function are recommended。

Frequency of Modifiable Cardiovascular Risk Factors Such as Obesity, Diabetes Mellitus and Hypertension in a Benin Rural Area

The fight against cardiovascular diseases requires the knowledge of their modifiable risk factors. This study aimed to assess the level of modifiable cardiovascular risk factors in a rural area in order to develop a prevention program. Methods: This is an analytical and cross-sectional study on data collected during a fairground medical consultation of adults from 20 to 25 May 2013, in both border districts of the municipality of Djidja (Agouna and Houto). The studied parameters were the capillary blood glucose profile, blood pressure profile, waist circumference (WC) and Body Mass Index (BMI). Diabetes is defined by a fasting blood glucose ≥ 1.26 g/L two times. Hypertension is defined according to the criteria of JNC VII and obesity by BMI ≥ 30 kg/m2;abdominal obesity is defined by a WC above 102 cm in men and 88 cm in women. Data were analyzed using SPSS software version 18.0. Results: A total of 926 people were included among whom 57.8% were women. The average age was 38.43 ± 15.84 years. The prevalence of diabetes mellitus was 2.9%. The prevalence of obesity (BMI ≥ 30 kg/m2) was 8.4%;10.8% of studied population had abdominal obesity and 19.2% had hypertension. Age above 35 years and obesity were significantly associated with hypertension. Risk factors of obesity (IMC ≥ 30 kg/m2) were the place of residence (Agouna), the female gender, age between 35 and 64 and abdominal obesity. Conclusion: The frequency of cardiovascular risk factors, although small compared to the national level, remains a concern in the investigated rural communities. This must lead to undertake a survey on the lifestyle and dietary habits of the inhabitants of these areas.

Correlation of second-trimester serum 25-OH-VitD3 with inflammatory factors and adipocytokines in patients with gestational diabetes mellitus

Objective: To investigate the correlation of second-trimester serum 25-OH-VitD3 with inflammatory factors and adipocytokines in patients with gestational diabetes mellitus. Methods: A total of 92 second-trimester pregnant women who were diagnosed with GDM in this hospital between December 2014 and January 2017 were selected as GDM group, and 80 healthy pregnant women who received antenatal care in this hospital during the same period were selected as normal control group. The serum levels of 25-OH-VitD3, inflammatory factors and adipocytokines were compared between the two groups of pregnant women, and Pearson test was used to evaluate the correlation of serum 25-OH-VitD3 level with inflammatory factors and adipocytokines in patients with GDM. Results: Serum 25-OH-VitD3 level of GDM group was lower than that of normal control group;serum inflammatory factors TNF-α, CRP and IL-6 levels were higher than those of normal control group while IL-10 level was lower than that of normal control group;serum adipocytokines RBP4 and VF levels were higher than those of normal control while APN level was lower than that of normal control group. Second-trimester serum 25-OH-VitD3 level of patients with GDM was directly correlated with the contents of inflammatory factors and adipocytokines. Conclusion: Second-trimester 25-OH-VitD3 deficiency in patients with GDM may be involved in the development of GDM through inflammatory factors and adipocytokines.