1.Effect of electroacupuncture combined with intradermal needling on simple obesity and serum intestinal lymphatic function-related factors.
Ming-Hui XIA ; Zhi YU ; Dong-Hua LIU ; Huo-Yan JI ; Bin XU
Chinese Acupuncture & Moxibustion 2022;42(9):966-970
OBJECTIVE:
To assess the efficacy of the combined treatment with electroacupuncture (EA) and intradermal needling on simple obesity and explore its underlying effect mechanism.
METHODS:
A total number of 116 patients with simple obesity were randomized into an observation group (58 cases, 3 cases dropped off and 2 cases removed) and a control group (58 cases, 4 cases dropped off and 1 cases removed). Patients in the control group received EA at Zhongwan (CV 12), Quchi (LI 11), Zusanli (ST 36), Pishu (BL 20), Weishu (BL 21), etc., for 30 min each time. On the base of the intervention as the control group, the patients in the observation group received the intradermal needling at Tianshu (ST 25), Daheng (SP 15), Zusanli (ST 36), Shangjuxu (ST 37), Quchi (LI 11), Pishu (BL 20) and Weishu (BL 21). In each group, the intervention was given once every two days, 3 times a week, consecutively for 3 months. Before and after treatment, the obesity indexes (body mass [BW], body mass index [BMI], body fat percentage [F%], adiposity [A] and waist circumference [WC]), the serum intestinal lymphatic function-related factors (vascular endothelial growth factor C [VEGF-C], delta-like ligand 4 [DLL4], adrenomedullin [ADM]), blood lipid (total cholesterol [TC], triglyceride [TG] and low density lipoprotein-cholesterol [LDL-C]), and fasting plasma glucose (FPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) were observed in the patients of both groups; and the efficacy was assessed.
RESULTS:
The effective rate was 88.7% (47/53) in the observation group, higher than 71.7% (38/53) in the control group (P<0.05). After treatment, except FPG in the control group, BW, BMI, F%, A, WC, and the concentrations of serum VEGF-C, DLL4 and ADM, as well as TC, TG, LDL-C, FBG, FINS and HOMA-IR were all reduced compared with those before treatment in both groups (P<0.05). The reduction ranges of BW, BMI, F%, A, WC, and the concentrations of serum VEGF-C, DLL4 and ADM, and TC, LDL-C, FINS and HOMA-IR in the observation group were all larger than those in the control group (P<0.05).
CONCLUSION
Electroacupuncture combined with intradermal needling can reduce body weight and lipid, and improve insulin resistance in treatment of simple obesity, which is achieved probably through inhibiting lymphangiogenesis and promoting lymphatic endothelial permeability.
Acupuncture Points
;
Blood Glucose/metabolism*
;
Cholesterol, LDL
;
Electroacupuncture
;
Humans
;
Insulin Resistance
;
Intestines
;
Lipids
;
Lymphocytes
;
Obesity/therapy*
;
Obesity, Morbid
;
Triglycerides
;
Vascular Endothelial Growth Factor C
2.Components and lipid-lowering effect of total saponins from underground part of Gynostemma pentaphyllum.
Fei TENG ; Xiang-Wei LI ; Min LI ; Dong-Dong FAN ; Jing-Jing ZHU ; Hui-Min GAO ; Zhi-Min WANG
China Journal of Chinese Materia Medica 2022;47(18):5022-5031
The saponins in different parts of Gynostemma pentaphyllum were analyzed via UPLC-Q-TOF-MS~E. A total of 46 saponins were identified, and the underground part had 26 saponins more than the aboveground part, most of which were trisaccharide saponins. The rat model of hyperlipidemia was established with high-fat diet. This study explored the lipid-lowering activity of total saponins in the underground part of G. pentaphyllum, so as to provide a theoretical basis for the comprehensive utilization of the underground part of G. pentaphyllum. A total of 99 healthy SD rats were randomly assigned into a blank group, a model group, a positive drug group, an aboveground total saponins group, and low-, medium-, and high-dose underground total saponins groups. Except the blank group, the other groups were fed with high-fat diet for 6 weeks. Then, the blood was collected from the orbital cavity to determine whether the modeling was successful according to the serum levels of total cholesterol(TC) and triglyceride(TG). After intragastric administration of the corresponding agents for 30 continuous days, the physical state of the rats were observed, and the body weight and liver specific gravity were measured. Furthermore, the levels of TC, TG, low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), alanine transaminase(ALT), aspartate transaminase(AST), bilirubin, and total bile acids in serum, as well as the levels of superoxide dismutase(SOD), malondialdehyde(MDA), peroxidase proliferator-activated receptor(PPAR-γ) in the liver tissue, were determined. The pathological changes of liver was observed via HE staining. The results showed that the aboveground total saponins and medium-and high-dose underground total saponins can treat hepatocyte steatosis, lower TC, TG, LDL-C, ALT, AST, total bilirubin, MDA, and PPAR-γ levels, and increase HDL-C and SOD levels in the model rats. The effect tended to be more obvious with the increase in dosage. Therefore, the total saponins in the underground part of G. pentaphyllum have good pharmacological effect of reducing blood lipid, which provides a theoretical basis for the comprehensive utilization of the underground part of G. pentaphyllum.
Alanine Transaminase/analysis*
;
Animals
;
Aspartate Aminotransferases/analysis*
;
Bile Acids and Salts/blood*
;
Bilirubin/blood*
;
Cholesterol, LDL/blood*
;
Diet, High-Fat/adverse effects*
;
Gynostemma/chemistry*
;
Hypolipidemic Agents/therapeutic use*
;
Lipoproteins, HDL/blood*
;
Liver/metabolism*
;
Malondialdehyde/analysis*
;
Peroxisome Proliferator-Activated Receptors/analysis*
;
Rats
;
Rats, Sprague-Dawley
;
Saponins/therapeutic use*
;
Superoxide Dismutase
;
Triglycerides/blood*
;
Trisaccharides/therapeutic use*
3.Correlation of serum androgen levels with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou.
Xu-Bo SHEN ; Shi-Min XIONG ; Fang-Wei LIU ; Yong-Jun SHI ; Qin YU ; Quan LI ; Lian-Bo SHEN ; Yuan-Zhong ZHOU
National Journal of Andrology 2018;24(4):311-316
ObjectiveTo investigate the relationship of the levels of serum androgens with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou.
METHODSUsing the stratified cluster sampling method, we conducted a questionnaire investigation and physical examinations among 437 men in Zunyi City. We divided the subjects into a middle-aged (40-64 [53.20 ± 7.41] years, n = 269) and an elderly group (=≥65 [70.63 ± 4.66] years, n = 168) and collected fasting elbow venous blood samples from them for measuring the levels of total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), total cholesterol (TCH), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), calculated free testosterone (cFT), free testosterone index (FTI), and testosterone secretion index (TSI).
RESULTSCompared with the elderly group, the middle-aged males showed significantly lower SHBG, LH, HDL and LDL, and higher cFT, FTI, TSI, TG and TCH (all P < 0.05). TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, while cFT was positively correlated with TCH, and so was FTI with TG, TCH with LDL, and TSI with TCH, HDL and LDL (all P < 0.05), but LH was negatively correlated with TG, TCH and LDL (all P < 0.05). Multivariate linear regression analysis showed that TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, and so was LH with TCH, HDL and LDL (all P < 0.05).
CONCLUSIONSIn the middle-aged and elderly men in Zunyi, low concentrations of TT, SHBG and LH were associated with the increased risk of high-TCH and -LDL dyslipidemia, low concentrations of TT and SHBG with that of high-TG dyslipidemia, while high concentrations of TT, SHBG and LH with that of low-HDL dyslipidemia.
Adult ; Aged ; Androgens ; blood ; China ; Cholesterol ; blood ; Dyslipidemias ; etiology ; Humans ; Lipid Metabolism ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Luteinizing Hormone ; Male ; Middle Aged ; Multivariate Analysis ; Sex Hormone-Binding Globulin ; Testosterone ; blood ; Triglycerides ; blood
4.A high-fat diet increases body fat mass and up-regulates expression of genes related to adipogenesis and inflammation in a genetically lean pig.
Xue-Fen YANG ; Yue-Qin QIU ; Li WANG ; Kai-Guo GAO ; Zong-Yong JIANG
Journal of Zhejiang University. Science. B 2018;19(11):884-894
Because of their physiological similarity to humans, pigs provide an excellent model for the study of obesity. This study evaluated diet-induced adiposity in genetically lean pigs and found that body weight and energy intake did not differ between controls and pigs fed the high-fat (HF) diet for three months. However, fat mass percentage, adipocyte size, concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), insulin, and leptin in plasma were significantly higher in HF pigs than in controls. The HF diet increased the expression in backfat tissue of genes responsible for cholesterol synthesis such as Insig-1 and Insig-2. Lipid metabolism-related genes including sterol regulatory element binding protein 1c (SREBP-1c), fatty acid synthase 1 (FASN1), diacylglycerol O-acyltransferase 2 (DGAT2), and fatty acid binding protein 4 (FABP4) were significantly up-regulated in backfat tissue, while the expression of proliferator-activated receptor-α (PPAR-α) and carnitine palmitoyl transferase 2 (CPT2), both involved in fatty acid oxidation, was reduced. In liver tissue, HF feeding significantly elevated the expression of SREBP-1c, FASN1, DGAT2, and hepatocyte nuclear factor-4α (HNF-4α) mRNAs. Microarray analysis further showed that the HF diet had a significant effect on the expression of 576 genes. Among these, 108 genes were related to 21 pathways, with 20 genes involved in adiposity deposition and 26 related to immune response. Our results suggest that an HF diet can induce genetically lean pigs into obesity with body fat mass expansion and adipose-related inflammation.
Adipocytes/cytology*
;
Adipogenesis/genetics*
;
Adipose Tissue/metabolism*
;
Adiposity
;
Animals
;
Body Weight
;
Cholesterol/blood*
;
Cholesterol, HDL/blood*
;
Cholesterol, LDL/blood*
;
Diet, High-Fat
;
Inflammation/genetics*
;
Insulin/blood*
;
Leptin/blood*
;
Lipid Metabolism
;
Male
;
Obesity/genetics*
;
Random Allocation
;
Swine
;
Triglycerides/blood*
5.Relationship between dairy products, fish and shellfish intake and metabolic syndrome risk factors in prediabetes: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-3) 2015.
Jeong Seop PARK ; Kyoung Yun KIM
Journal of Nutrition and Health 2017;50(5):447-459
PURPOSE: Metabolic Syndrome (MetS) is defined as a cluster of inter-connected metabolic disorders involving the glucose metabolism, dyslipidaemia, high blood pressure, and abdominal obesity. The worldwide prevalence has been rapidly increasing to approximately 20~25%, and the prevalence in Korea as of 2012 was reported to be 31.3%. The association of MetS with various diseases needs to be analyzed by conducting an investigation of frequently consumed foods, such as dairy products, fish, and shellfish in prediabetic subjects. METHODS: The dietary intake of subjects who met the criteria of the study from January to December 2015 was assessed using the 24-hour recall method. After adjusting the age, sex, BMI, and total energy intake, which are confounding factors that may affect the dietary intake of the subjects, the associations of dairy products, fish, and shellfish intake with the MetS risk factors was analyzed. RESULTS: In prediabetes, the intake of subjects who consumed more than the dairy products median (187.0 g) and the elevation risk of TC [OR, 2.369; 95% CI, 1.057 to 5.312] showed a significant positive association. In prediabetes, the intake of subjects who consumed more than the fish and shellfish median (44.0 g) and the elevation risk of BP showed a significantly weak negative association [OR, 0.073; 95% CI, 0.010 to 0.520]. The probability that the blood LDL cholesterol was ≥ 100 mg/dL decreased 0.397 times [95% CI, 0.189 to 0.832]. CONCLUSION: To control the metabolic risk factors of pre-diabetic and vascular disease subjects, proper dairy, fish and shellfish intake will be important.
Blood Pressure
;
Cholesterol
;
Cholesterol, LDL
;
Dairy Products*
;
Energy Intake
;
Glucose
;
Hypertension
;
Korea*
;
Metabolism
;
Methods
;
Nutrition Surveys*
;
Obesity, Abdominal
;
Prediabetic State*
;
Prevalence
;
Risk Factors*
;
Shellfish*
;
Vascular Diseases
6.Effects of Rapamycin on Clinical Manifestations and Blood Lipid Parameters in Different Preeclampsia-like Mouse Models.
Yan-Hong YI ; Zi YANG ; Yi-Wei HAN ; Jing HUAI
Chinese Medical Journal 2017;130(9):1033-1041
BACKGROUNDThe pathogenesis of some types of preeclampsia is related to fatty acid oxidation disorders. Rapamycin can regulate fatty acid metabolism. This study aimed to investigate the effects of rapamycin on the clinical manifestations and blood lipid parameters in different preeclampsia-like mouse models.
METHODSTwo preeclampsia-like mouse models and a control group were established: L-NA (injected with Nω-nitro-L-arginine methyl ester), LPS (injected with lipopolysaccharide), and the control group with normal saline (NS). The mouse models were established at preimplantation (PI), early- and late-pregnancy (EP, LP) according to the time of pregnancy. The administration of rapamycin (RA; L-NA+RA, LPS+RA, and NS+RA) or vehicle as controls (C; L-NA+C, LPS+C, NS+C) were followed on the 2nd day after the mouse models' establishment. Each subgroup consisted of eight pregnant mice. The mean arterial pressure (MAP), 24-h urinary protein, blood lipid, fetus, and placental weight were measured. The histopathological changes and lipid deposition of the liver and placenta were observed. Student's t-test was used for comparing two groups. Repeated measures analysis of variance was used for blood pressure analysis. Qualitative data were compared by Chi-square test.
RESULTSThe MAP and 24-h urinary protein in the PI, EP, and LP subgroups of the L-NA+C and LPS+C groups were significantly higher compared with the respective variables in the NS+C group (P < 0.05). The preeclampsia-like mouse models were established successfully. There was no significant difference in the MAP between the PI, EP, and LP subgroups of the L-NA+RA and L-NA+C groups and the LPS+RA and LPS+C groups. The 24-h urine protein levels in the PI and EP subgroups of the L-NA+RA group were significantly lower compared with the respective levels in the L-NA+C groups (1037 ± 63 vs. 2127 ± 593 μg; 976 ± 42 vs. 1238 ± 72 μg; bothP < 0.05), also this effect appeared similar in the PI and EP subgroups of the LPS+RA and LPS+C groups (1022 ± 246 vs. 2141 ± 432 μg; 951 ± 41 vs. 1308 ± 30 μg; bothP < 0.05). The levels of serum-free fatty acid (FFA) in the PI and EP subgroups of the L-NA+RA groups were significantly lower compared with the respective levels in the L-NA+C group (2.49 ± 0.44 vs. 3.30 ± 0.18 mEq/L; 2.23 ± 0.29 vs. 2.84 ± 0.14 mEq/L; bothP < 0.05). The levels of triglycerides (TG) and total cholesterol in the PI subgroup of the L-NA+RA group were significantly lower compared with the respective levels in the L-NA+C (1.51 ± 0.16 vs. 2.41 ± 0.37 mmol/L; 2.11 ± 0.17 vs. 2.47 ± 0.26 mmol/L; bothP < 0.05), whereas high-density lipoprotein serum concentration was significantly higher (1.22 ± 0.19 vs. 0.87 ± 0.15 mmol/L;P < 0.05) and low-density lipoprotein serum concentration did not exhibit a significant difference. There were no significant differences in the FFA of the PI, EP, and LP subgroups between the LPS+RA and the LPS+C groups. The levels of TG in the PI subgroup of the LPS+RA group were significantly lower compared with the respective levels in the LPS+C group (0.97 ± 0.05 vs. 1.22 ± 0.08 mmol/L;P < 0.05).
CONCLUSIONRapamycin can improve clinical manifestations and blood lipid profile in part of the preeclampsia-like mouse models.
Animals ; Blood Pressure ; drug effects ; Chi-Square Distribution ; Cholesterol ; blood ; Disease Models, Animal ; Female ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Mice ; Mice, Inbred C57BL ; Placenta ; drug effects ; metabolism ; Pre-Eclampsia ; blood ; drug therapy ; Pregnancy ; Pregnancy Outcome ; Sirolimus ; therapeutic use ; Triglycerides ; administration & dosage ; blood
7.Darapladib, a Lipoprotein-Associated Phospholipase A2 Inhibitor, Reduces Rho Kinase Activity in Atherosclerosis.
Juan ZHANG ; Dong Ling XU ; Xiao Bo LIU ; Shao Jie BI ; Tong ZHAO ; Shu Jian SUI ; Xiao Ping JI ; Qing Hua LU
Yonsei Medical Journal 2016;57(2):321-327
PURPOSE: Increased lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and Rho kinase activity may be associated with atherosclerosis. The principal aim of this study was to examine whether darapladib (a selective Lp-PLA2 inhibitor) could reduce the elevated Lp-PLA2 and Rho kinase activity in atherosclerosis. MATERIALS AND METHODS: Studies were performed in male Sprague-Dawley rats. The atherosclerosis rats were prepared by feeding them with a high-cholesterol diet for 10 weeks. Low-dose darapladib (25 mg.kg-1.d-1) and high-dose darapladib (50 mg.kg-1.d-1) interventions were then administered over the course of 2 weeks. RESULTS: The serum levels of triglycerides, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hs-CRP), and Lp-PLA2, significantly increased in atherosclerosis model groups, as did Rho kinase activity and cardiomyocyte apoptosis (p<0.05 vs. sham group), whereas nitric oxide (NO) production was reduced. Levels of TC, LDL-C, CRP, Lp-PLA2, and Rho kinase activity were respectively reduced in darapladib groups, whereas NO production was enhanced. When compared to the low-dose darapladib group, the reduction of the levels of TC, LDL-C, CRP, and Lp-PLA2 was more prominent in the high-dose darapladib group (p<0.05), and the increase of NO production was more prominent (p<0.05). Cardiomyocyte apoptosis of the high-dose darapladib group was also significantly reduced compared to the low-dose darapladib group (p<0.05). However, there was no significant difference in Rho kinase activity between the low-dose darapladib group and the high-dose darapladib group (p>0.05). CONCLUSION: Darapladib, a Lp-PLA2 inhibitor, leads to cardiovascular protection that might be mediated by its inhibition of both Rho kinase and Lp-PLA2 in atherosclerosis.
1-Alkyl-2-acetylglycerophosphocholine Esterase/*antagonists & inhibitors/blood/drug effects
;
Animals
;
Atherosclerosis/blood/*drug therapy/*enzymology
;
*Benzaldehydes
;
C-Reactive Protein/metabolism
;
Cholesterol/blood
;
Cholesterol, HDL/blood
;
Cholesterol, LDL/blood
;
Dose-Response Relationship, Drug
;
Male
;
*Oximes
;
Phospholipase A2 Inhibitors/*administration & dosage/adverse effects
;
Rats
;
Rats, Sprague-Dawley
;
Triglycerides/blood
;
rho-Associated Kinases/*metabolism
8.High-density lipoprotein cholesterol and in-hospital mortality in patients with acute aortic dissection.
Xin-Tian LIU ; Xing-Wei HE ; Rong TAN ; Wan-Jun LIU ; Bei WANG ; Yu-Jian LIU ; Tao WANG ; Cheng-Wei LIU ; Xi SU ; He-Song ZENG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2016;36(3):364-367
The association between high-density lipoprotein cholesterol (HDL-C) and mortality in patients with acute aortic dissection (AAD) is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group (n=585), low HDL-C group (n=343) had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group (21.6% vs. 12.6%, log-rank=10.869, P=0.001). After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference (adjusted hazard ratio, 1.23; 95% confidence interval, 0.86-1.77; P=0.259). Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.
Acute Disease
;
Adult
;
Aged
;
Alanine Transaminase
;
blood
;
Aneurysm, Dissecting
;
blood
;
diagnosis
;
mortality
;
pathology
;
Aortic Aneurysm
;
blood
;
diagnosis
;
mortality
;
pathology
;
Biomarkers
;
blood
;
Blood Glucose
;
metabolism
;
Blood Pressure
;
Blood Urea Nitrogen
;
Cholesterol, HDL
;
blood
;
Cholesterol, LDL
;
blood
;
Creatinine
;
blood
;
Female
;
Hospital Mortality
;
Humans
;
Male
;
Middle Aged
;
Proportional Hazards Models
;
Risk Factors
;
Uric Acid
;
blood
9.An Analysis on the Association between Lipid Metabolism and Low Birth Body Mass and Relative Factors among Rural and Urban Adolescents.
Shao-ying LIU ; Tong WANG ; Juan XIE ; Xin-yue ZHI
Acta Academiae Medicinae Sinicae 2016;38(2):210-216
OBJECTIVETo analyze the status of lipid metabolism and the relationship between low birth body mass and lipid metabolism disorders in adolescents with different economic and cultural backgrounds.
METHODSTotally 1700 adolescents from urban and rural areas aged 12-18 years were selected in 2013. The lipid profiles were determined, and a questionnaire-based survey was conducted.
RESULTSAmong normal birth body mass adolescents, girls obtained a high density lipoprotein in both urban and rural areas, low density lipoprotein cholesterol level was higher for city girls, rural boys and urban girls obtained higher total cholesterol level, the differences all reached statistical significance. While among the low birth body mass adolescents, higher level of total cholesterol for urban boys was detected, with statistically significance. When compared between rural and urban areas, high density lipoprotein cholesterol level for urban adolescents was lower in normal birth body mass adolescents, while total cholesterol level for urban adolescents was higher, both with statistically significance. While the comparison between different birth body mass adolescents suggested that the normal birth body mass adolescents obtained a higher high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride and total cholesterol level. When analyze the influenced factors of disorder of lipid metabolism, the Results suggest that low birth body mass, maternal pregnancy body mass increasing, lipid homeostasis family history, absence of breakfast, unhealthy snack habit, abnormal of systolic blood pressure and pulse pressure increasing were related to the occurrence of dyslipidemia.
CONCLUSIONSLow birth body mass is related with lipid metabolism in early puberty. Low birth body mass, family history of abnormal lipid metabolism, and poor diet habits can increase the risk of abnormal lipid metabolism in puberty.
Adolescent ; Birth Weight ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Dyslipidemias ; epidemiology ; Female ; Humans ; Lipid Metabolism ; Male ; Pregnancy ; Risk Factors ; Rural Population ; Sexual Maturation ; Triglycerides ; blood ; Urban Population
10.Predictors of poor glycaemic control in older patients with type 2 diabetes mellitus.
Shariff-Ghazali SAZLINA ; Ismail MASTURA ; Ai Theng CHEONG ; Adam Bujang MOHAMAD ; Haniff JAMAIYAH ; Ping Yein LEE ; Syed Abdul Rahman Syed ALWI ; Boon How CHEW
Singapore medical journal 2015;56(5):284-290
INTRODUCTIONWe assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia.
METHODSThis cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008-2009.
RESULTSPredictors of poor glycaemic control were: age groups 60-69 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.66-2.33) and 70-79 years (OR 1.43, 95% CI 1.20-1.71); Malay (OR 1.53, 95% CI 1.41-1.66) and Indian (OR 1.32, 95% CI 1.19-1.46) ethnicities; T2DM durations of 5-10 years (OR 1.46, 95% CI 1.35-1.58) and > 10 years (OR 1.75, 95% CI 1.59-1.91); the use of oral antidiabetic agents only (OR 5.86, 95% CI 3.32-10.34), insulin only (OR 17.93, 95% CI 9.91-32.43), and oral antidiabetic agents and insulin (OR 29.42, 95% CI 16.47-52.53); and elevated blood pressure (OR 1.10, 95% CI 1.01-1.20), low-density lipoprotein cholesterol (OR 1.48, 95% CI 1.38-1.59) and triglycerides (OR 1.61, 95% CI 1.51-1.73). Hypertension (OR 0.71, 95% CI 0.64-0.80), hypertension and dyslipidaemia (OR 0.68, 95% CI 0.61-0.75), pre-obesity (OR 0.89, 95% CI 0.82-0.98) and obesity (OR 0.76, 95% CI 0.70-0.84) were less likely to be associated with poor glycaemic control.
CONCLUSIONYoung-old and middle-old age groups (i.e. < 80 years), Malay and Indian ethnicities, longer T2DM duration, the use of pharmacological agents, and elevated blood pressure and lipid levels were associated with poor glycaemic control. The presence of comorbidities, pre-obesity and obesity were less likely to be associated with poor glycaemic control.
Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Blood Pressure ; Cholesterol, LDL ; blood ; Comorbidity ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; blood ; complications ; ethnology ; Female ; Glycated Hemoglobin A ; metabolism ; Humans ; Hyperglycemia ; blood ; Hypertension ; complications ; Hypoglycemic Agents ; therapeutic use ; Insulin ; blood ; Male ; Middle Aged ; Obesity ; complications ; Registries ; Sex Factors ; Singapore ; Triglycerides ; blood

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