1.Study on association between insulin resistance and intermediate risk factors for non-communicable diseases
Khangai E ; Batzorig B ; Bayarbold D ; Enkhtur Ya ; Altaisaikhan Kh ; Oyunsuren E ; Oyuntugs B
Mongolian Journal of Health Sciences 2025;86(2):60-64
Background:
In Mongolia, the prevalence of non-communicable diseases and their intermediate risk factors has continuously
increased in recent years. From results of early detection and prevalence studies of non-communicable diseases in
Mongolia, studies linking intermediate risk factors to insulin resistance are scarce.
Aim:
To identify the prevalence of insulin resistance among the population and study its connection with intermediate
risk factors of non-communicable diseases.
Materials and Methods:
This study was approved by the MNUMS Ethics Committee on February 23, 2024 (2024/3-
02), and was conducted based on the data of participants who took part in the “Population-based Preventive and Early
Detection Screening of Infectious and Non-Infectious Diseases” organized by the Mongolian government from 2022 to
2023. Insulin resistance was identified using the triglyceride-glucose index (TyG), calculated by the formula Ln [fasting
triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. “Ln” refers to the natural logarithm, based on Euler’s number, approximately
2.71828. TyG levels were classified into low risk (<8.5), medium risk (8.5-9.0), and high risk (>9.0). Defined
intermediate risk factors for non-communicable diseases according to stages of hypertension and diabetes.
Results:
The mean age of participants was 44.3±15.2 years, with 39.2% (n=49,270) male and 41.4% (n=49,749) residing
in urban areas. Among the participants, 59.1% had overweight or obesity, 23.6% had diabetes or impaired fasting glucose,
61.4% had hypertension, and 19.7% had elevated triglycerides. Analyzing by levels of insulin resistance risk, 62.8% of
the population had low risk, 22.5% medium risk, and 14.7% high risk. Comparing systolic blood pressure across levels
of insulin resistance risk showed that even without central obesity or diabetes, as the level of insulin resistance increased,
the level of systolic blood pressure also increased (low risk group: 117.0±11.7, medium risk group: 121.1±10.9, high risk
group: 123.5±16.2 mmHg). Regression analysis of the risk of hypertension by insulin resistance risk level showed that the
risk increased with higher levels of insulin resistance (medium risk group OR=1.35, p<0.0001; high risk group OR=1.63,
p<0.0001).
Conclusion
22.5% of the population is at medium risk and 14.7% at high risk of insulin resistance. The increase in hypertension
risk with higher insulin resistance levels is statistically significant, independent of central obesity and diabetes
stages.
2.Associations of secondary risk factors of non-communicable diseases
Khangai E ; Batzorig B ; Narantuya D ; Enkhtur Ya ; Oyuntugs B ; Bayarbold Dangaa ; Oyunsuren E
Diagnosis 2024;111(4):51-58
Background:
Obesity and metabolic disorders are significant contributors to hypertension and cardiovascular disease
(CVD). While body mass index (BMI) and waist circumference are known to be associated with systolic blood pressure (SBP), the interplay between adiposity, glucose levels, triglycerides, and SBP is
not fully understood. This study aims to investigate the relationships between BMI, waist circumference, glucose, triglycerides, and SBP in a large population-based cohort.
Methods:
A cross-sectional analysis was conducted on [insert total number] participants with complete data on BMI, waist circumference, blood pressure, glucose, and triglycerides. Descriptive statistics, ANOVA, Pearson correlations, mediation analysis, and multiple regression were used to explore the associations between variables. The moderation effect of glucose on the BMI-SBP relationship
was examined using an interaction term in the regression model.
Results:
The mean age of the study population was 44.3 ± 15.2 years. The mean BMI was 26.7 ± 4.9 kg/m², and 22.7% of participants were classified as obese. Central obesity, measured by waist
circumference, was prevalent in 55.9% of the population. BMI, waist circumference, glucose, and triglycerides were significantly associated with SBP (p < 0.0001). Mediation analysis showed that waist circumference partially mediated the effect of BMI on SBP. The interaction term for BMI and
glucose was significant (β = 0.32, p < 0.05), indicating that glucose levels moderated the relationship between BMI and SBP, with higher glucose levels amplifying the hypertensive effect of BMI.
Conclusion
This study highlights the complex interplay between BMI, waist circumference, glucose, triglycerides, and SBP. Waist circumference partially mediates the effect of BMI on SBP, and glucose levels moderate this relationship, amplifying the impact of obesity on blood pressure.
3.ASSESSING EDUCATIONAL ENVIRONMENT IN NURSING SCHOOL OF MNUMS
Khangai E ; Usukhbayar M ; Bayarbat G ; Oyuntsetseg S ; Bolorsaikhan O ; Oyungoo B
Innovation 2017;11(2):77-80
BACKGROUND. To evaluate educational environment, it is important to use confidential
and accepted tool. Dundee Ready Education Environment Measure (DREEM) (3) is a
globally accepted and widely used tool to measure the education environment. Regular
assessment of educational environment to evaluate teachers’ teaching method, students’
perception and their outcome and making the necessary adjustment to it is one of the factors
affecting students’ knowledge, clinical practice and their motivation (4). In the MNUMS
program, educational environmental assessment is one of the most important parts and
we are unaware of any report of research work. Therefore, the researchers decide to carry
this study. AIM OF THE STUDY. This study aimed to evaluate the educational environment
in Nursing school of MNUMS using globally accepted DREEM Questionnaire.
MATERIALS AND METHODS. This cross-sectional analytic study was carried out in Faculty
of Nursing in Darkhan, Dornogobi and Gobi-Altai aimag out of 9 branch school of
MNUMS during the academic year 2015-2016 and 2016-2017. DREEM questionnaire was
used to collect data from 306 nursing students. RESULT. Most of the participants were
female accounted around 89.9% (275) and male were 10.1% (31). By age, age of 17-19
were 25.5%(78), 20-22 were 52.0% (159), 23-25 were 15.0%(46), >26 were 7.5% (23). The
mean item score was highest in Dornogobi school of 3.8 and lowest in Nursing school of
3.6. 4th year students’ 68.6% (210) agreed to “more on positive side” for their academic
self perception and 22.5% (69) agreed “moving in right direction” for their academic self
perception. All domains were statistically significant specially the perception of curriculum
(0.854**) and perception of learning (0.803**) have high correlation. On the other hand,
perception of educational atmosphere (0.444**) and perception of teachers have moderate
correlation. The reliability of questionnaire was confirmed by Cronbach alpha and it is
counted as reliable if it is more than 0.7. The perception of curriculum was relatively low in
2nd year students but higher in 3rd year students. The perception of educational atmosphere
was relatively low in 4th year students but higher in 1st year students.
CONCLUSION. The nursing school program is in same level. Students are satisfied with
their academic self perception and perception of teachers. The result showed that 68.2%
(209) of students consider positive aspect of educational environment (p<0.001). Students
of all 4 school of MNUMS with same level of nursing school program are satisfied with
their knowledge, clinical skills and educational atmosphere among the students. Dornogobi
school students’ 65% assessed perception of teacher as “model instruction”.