To characterize the epidemiologic profiles of prediabetes mellitus (preDM), diabetes mellitus (DM), and hypertension (HTN) in Qataris using the nationally representative 2012 Qatar STEPwise Survey.
A ...secondary data analysis of a cross-sectional survey that included 2,497 Qatari nationals aged 18-64 years. Descriptive and analytical statistical analyses were conducted.
Prevalence of preDM, DM, and HTN in Qataris aged 18-64 years was 11.9% (95% confidence interval CI 9.6%-14.7%), 10.4% (95% CI 8.4%-12.9%), and 32.9% (95% CI 30.4%-35.6%), respectively. Age was the common factor associated with the three conditions. Adjusted analyses showed that unhealthy diet (adjusted odds ratio (aOR) = 1.84, 95% CI 1.01-3.36) was significantly associated with preDM; that physical inactivity (aOR = 1.66, 95% CI 1.12-2.46), central obesity (aOR = 2.08, 95% CI 1.02-4.26), and HTN (aOR = 2.18, 95% CI 1.40-3.38) were significantly associated with DM; and that DM (aOR = 2.07, 95% CI 1.34-3.22) was significantly associated with HTN. Population attributable fraction of preDM associated with unhealthy diet was 7.7%; of DM associated with physical inactivity, central obesity, and HTN, respectively, was 14.9%, 39.8%, and 17.5%; and of HTN associated with DM was 3.0%.
One in five Qataris is living with either preDM or DM, and one in three is living with HTN, conditions that were found to be primarily driven by lifestyle factors. Prevention, control, and management of these conditions should be a national priority to reduce their disease burden and associated disease sequelae.
Plasma elevated levels of branched chain amino acids (BCAA) and aromatic amino acids (AAA) have been associated with obesity and insulin resistance, but their relationship to stimulated insulin ...resistance (IR) in PCOS and in response to exercise is unknown. Indeed, it is unknown whether the mechanism of IR in PCOS is mediated through changes in the metabolome.
Twelve women with polycystic ovary syndrome (PCOS) and ten age and body mass index matched controls completed an 8 week supervised exercise program at 60% maximal oxygen consumption. Before and after the exercise program, all participants underwent maximal IR stimulation with intralipid infusions followed by insulin sensitivity (IS) measurement by hyperinsulinaemic euglycaemic clamps. Amino acid profiles and metabolites were taken at baseline and at maximal insulin resistance stimulation before and after the exercise program.
At baseline, PCOS subjects showed increased leucine/isoleucine, glutamate, methionine, ornithine, phenylalanine, tyrosine and proline (
< 0.05) that, following exercise, did not differ from controls. While compering within the groups, no significant changes in the amino acid levels before and after exercise were observed. Exercise improved VO2 max (
< 0.01) but did not alter weight. Amino acid profiles were unaffected by an acute increase in IR induced by the lipid infusion. IS was lower in PCOS (
< 0.001) and was further decreased by the lipid infusion in both PCOS and controls. Although, exercise improved IS in both PCOS and in controls, the IS remained compromised in PCOS.
The baseline amino acid profile in PCOS reflected that seen in obese subjects and differed to controls. After exercise, and despite no change in weight in either group, there were no differences in the amino acid profile between PCOS and controls. This shows that exercise may normalize the amino acid metabolome, irrespective of weight.
: ISRCTN42448814.
Background: As the prevalence of diabetes is increasing worldwide, our aim is to assess the recent cardiovascular and economic trend in outcomes of patients with stroke and diabetes in the U.S.
...Methods: Data from the National Inpatient Sample was analyzed between 2005 to 2014. We studied: In-hospital mortality, length of stay (LoS) and overall hospital charges in patients hospitalized for stroke, >18 years of age and known to have diabetes.
Results: The prevalence of diabetes gradually increased from 28.2% to 35.5% in all patients hospitalized for stroke (p trend<0.001) between 2005 and 2014. In those patients with diabetes, mean (SD) age slightly decreased from 70 (13) years to 69 (13) years (p trend <0.001). Interestingly, hospitalization for stroke increased from 17.4 to 20.0/100 000 U.S. adults (p trend <0.001). However, in-hospital age-adjusted mortality decreased from 4.64% to 3.73% (p trend <0.001). Age-adjusted mortality of hemorrhagic strokes - which represent only a small proportion of all strokes- decreased from 28.1% to 23.1%, that of ischemic strokes decreased from 3.23% to 2.48% (p trend <0.01 for both) whereas that of TIA was almost stable and lower than 0.2%. As expected, total charges of hospital stay almost doubled as they went up from 15,970 to 31,018 USD/stay (adjusted for inflation). Nevertheless, median (IQR) LoS slightly decreased from 4 (2-6) to 3 (2-6) days (p trend <0.05).
Conclusion: Our preliminary data show that the prevalence of diabetes in patients hospitalized for stroke is gradually increasing. Moreover, hospitalization for stroke is also increasing. Nevertheless, in-hospital mortality is on a descending slope, which comes at a price of an almost 2-fold increase in hospital charges from 2005 to 2014.
Disclosure
A. Tabbalat: None. S.R. Dargham: None. M.B. Elshazly: Stock/Shareholder; Self; Ember Medical. C. Abi Khalil: None.
Summary
Objective
Anti‐Müllerian hormone (AMH) is derived from the small antral follicles, and an elevated level has been suggested to add value to the Rotterdam criteria for the diagnosis of PCOS in ...cases of diagnostic uncertainty. Therefore, the role of AMH in the classical phenotype of PCOS was defined within a Caucasian population.
Design
This was a cross‐sectional study.
Patients
Sixty Five women without PCOS and 110 women with PCOS fulfilling all 3 diagnostic Rotterdam criteria.
Measurements
The main outcomes were the utility of serum AMH for the diagnosis of PCOS and its relationship to the metabolic parameters.
Results
Anti‐Müllerian hormone was increased in PCOS compared to controls (P < .001). Areas under the receiver operator curve showed AMH to be predictive of PCOS (0.76) using a cut‐off AMH of 46 pmol/L, which is derived from the 95th percentile of the controls that gave a 41% sensitivity and 86% specificity; an AMH cut‐off of 35 pmol/L gave a 55% sensitivity and 79% specificity. Age‐ and BMI‐adjusted multiple logistic regression showed that AMH was more predictive of PCOS independently of either serum testosterone (T) (OR = 4.04; 95% CI 1.42‐11.11; P = .007) or free androgen index (FAI) (OR = 3.90; 95% CI 1.40‐10.83; P = .009).
Conclusion
Whilst an elevated AMH has poor sensitivity, it is fourfold more likely to be associated with a diagnosis of PCOS, and supplementary to biochemical parameters will make a positive diagnosis of PCOS in 22% of patients when neither serum testosterone nor FAI is elevated.
We developed a diabetes risk score using a novel analytical approach and tested its diagnostic performance to detect individuals at high risk of diabetes, by applying it to the Qatari population. A ...representative random sample of 5,000 Qataris selected at different time points was simulated using a diabetes mathematical model. Logistic regression was used to derive the score using age, sex, obesity, smoking, and physical inactivity as predictive variables. Performance diagnostics, validity, and potential yields of a diabetes testing program were evaluated. In 2020, the area under the curve (AUC) was 0.79 and sensitivity and specificity were 79.0% and 66.8%, respectively. Positive and negative predictive values (PPV and NPV) were 36.1% and 93.0%, with 42.0% of Qataris being at high diabetes risk. In 2030, projected AUC was 0.78 and sensitivity and specificity were 77.5% and 65.8%. PPV and NPV were 36.8% and 92.0%, with 43.0% of Qataris being at high diabetes risk. In 2050, AUC was 0.76 and sensitivity and specificity were 74.4% and 64.5%. PPV and NPV were 40.4% and 88.7%, with 45.0% of Qataris being at high diabetes risk. This model-based score demonstrated comparable performance to a data-derived score. The derived self-complete risk score provides an effective tool for initial diabetes screening, and for targeted lifestyle counselling and prevention programs.
•Polycystic ovary syndrome (PCOS) is associated with vitamin D deficiency; both associate with increased cardiovascular risk.•We addressed if PCOS plus vitamin D deficiency exacerbates cardiovascular ...and metabolic characteristics in PCOS women.•Vitamin D deficiency did not exacerbate insulin resistance, androgen, inflammation or cardiovascular risk in PCOS women.
Polycystic ovary syndrome (PCOS) is associated with vitamin D deficiency (25-hydroxyvitamin D (25(OH)D), and both are associated with increased cardiovascular risk; therefore, the combination of PCOS and moderate vitamin D deficiency may exacerbate the cardiovascular and metabolic characteristics in women with PCOS. This study sought to address this question.
In this retrospective, cross-sectional study, demographic and metabolic data from women aged 18–40 years from the Qatar Biobank (QBB) (78 diagnosed with PCOS, 641 controls) was analyzed.
Moderate vitamin D deficiency was seen in both normal and PCOS cohorts irrespective of body mass index (BMI) stratification into normal, overweight and obese. Significant differences in free androgen index (FAI) and high density lipoproteins (HDL) (p < 0.05) were seen in PCOS irrespective of BMI, though insulin resistance and increased C-reactive protein (CRP) (p < 0.05) were seen only in obese PCOS subjects; however, there was no correlation (Pearson coefficient) of any these parameters with vitamin D for women with or without PCOS, nor when vitamin D deficiency was compared to vitamin D insufficiency (above and below 20 ng/mL, respectively) between the normal and PCOS groups.
Moderate vitamin D deficiency did not associate with nor exacerbate insulin resistance, androgen levels, inflammation or cardiovascular risk indices in women with PCOS, suggesting that a prospective study on vitamin D deficiency to confirm non-causality is required.
•Performances of five commercial ELISA for detecting anti-SARS-CoV-2 IgG was evaluated.•Samples were from diverse nationalities and the negative group contained seropositive samples for other ...HCoV.•All assays showed low sensitivity during the early stages; however, it was greatly improved overtime.•Lionex showed the highest specificity, followed by EDI and Dia.Pro, NovaTec, and lastly AnshLabs.•Lionex demonstrated the best performance and does not cross-react with any other HCoV.
To evaluate and compare the performances of five commercial ELISA assays (EDI, AnshLabs, Dia.Pro, NovaTec, and Lionex) for detecting anti-SARS-CoV-2 IgG.
Seventy negative control samples (collected before the COVID-19 pandemic) and samples from 101 RT-PCR-confirmed SARS-CoV-2 patients (collected at different time points from symptom onset: ≤7, 8–14 and >14 days) were used to compare the sensitivity, specificity, agreement, and positive and negative predictive values of each assay with RT-PCR. A concordance assessment between the five assays was also conducted. Cross-reactivity with other HCoV, non-HCoV respiratory viruses, non-respiratory viruses, and nuclear antigens was investigated.
Lionex showed the highest specificity (98.6%; 95% CI 92.3–99.8), followed by EDI and Dia.Pro (97.1%; 95% CI 90.2–99.2), NovaTec (85.7%; 95% CI 75.7–92.1), then AnshLabs (75.7%; 95% CI 64.5–84.2). All ELISA kits cross-reacted with one anti-MERS IgG-positive sample, except Lionex. The sensitivity was low during the early stages of the disease but improved over time. After 14 days from symptom onset, Lionex and NovaTec showed the highest sensitivity at 87.9% (95% CI 72.7–95.2) and 86.4% (95% CI 78.5–91.7), respectively. The agreement with RT-PCR results based on Cohen’s kappa was as follows: Lionex (0.89) > NovaTec (0.70) > Dia.Pro (0.69) > AnshLabs (0.63) > EDI (0.55).
The Lionex and NovaLisa IgG ELISA kits, demonstrated the best overall performance.
To determine if metabolic characteristics differed in women with and without polycystic ovary syndrome (PCOS) between a Caucasian and Middle East population. Comparative cross-sectional analysis. ...Demographic and metabolic data from Middle Eastern women from Qatar Biobank (97 with PCOS, 622 controls) were compared to a Caucasian PCOS biobank in Hull UK (108 with PCOS, 69 controls). In both populations, PCOS women showed a worse cardiovascular risk profile of increased systolic and diastolic blood pressure, increased C-reactive protein (CRP), reduced HDL, insulin resistance as well as increased androgens compared to their respective controls without PCOS. UK women without PCOS had higher systolic and diastolic blood pressures, and increased testosterone results (p < 0.01) compared to Middle Eastern women without PCOS who had higher inflammatory markers (WBC and CRP), HDL and insulin resistance (p < 0.001). UK PCOS women had a higher body mass index, systolic and diastolic blood pressures, triglycerides (p < 0.01), whilst Middle Eastern PCOS women showed increased testosterone, free androgen index, HDL and CRP (P < 0.01). There was no difference in insulin or insulin resistance between the two PCOS cohorts. This study highlights ethnic population differences because, whilst cardiovascular risk indices were increased for both PCOS cohorts, this may be for different reasons: BMI, waist and hip measurements, systolic and diastolic blood pressure, and triglycerides were higher in the UK cohort whilst testosterone, HDL and CRP were higher in the Middle East population. Insulin resistance did not differ between the two PCOS populations despite differences in BMI.
We aimed to characterize the type 2 diabetes mellitus (T2DM) epidemic and the role of key risk factors in Jordan between 1990-2050, and to forecast the T2DM-related costs. A recently-developed ...population-level T2DM mathematical model was adapted and applied to Jordan. The model was fitted to six population-based survey data collected between 1990 and 2017. T2DM prevalence was 14.0% in 1990, and projected to be 16.0% in 2020, and 20.6% in 2050. The total predicted number of T2DM cases were 218,326 (12,313 were new cases) in 1990, 702,326 (36,941 were new cases) in 2020, and 1.9 million (79,419 were new cases) in 2050. Out of Jordan's total health expenditure, 19.0% in 1990, 21.1% in 2020, and 25.2% in 2050 was forecasted to be spent on T2DM. The proportion of T2DM incident cases attributed to obesity was 55.6% in 1990, 59.5% in 2020, and 62.6% in 2050. Meanwhile, the combined contribution of smoking and physical inactivity hovered around 5% between 1990 and 2050. Jordan's T2DM epidemic is predicted to grow sizably in the next three decades, driven by population ageing and high and increasing obesity levels. The national strategy to prevent T2DM needs to be strengthened by focusing it on preventive interventions targeting T2DM and key risk factors.
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