SHIELD Investigators' Group. The relationship of body mass index to diabetes mellitus, hypertension, and dyslipidaemia: comparison of data from 2 national surveys

Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY 40213, USA.
International Journal of Clinical Practice (Impact Factor: 2.57). 05/2007; 61(5):737-47. DOI: 10.1111/j.1742-1241.2007.01336.x
Source: PubMed


The objectives of this study were to explore the relation between body mass index (BMI) and prevalence of diabetes mellitus, hypertension and dyslipidaemia; examine BMI distributions among patients with these conditions; and compare results from two national surveys. The Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) 2004 screening questionnaire (mailed survey) and the National Health and Nutrition Examination Surveys (NHANES) 1999-2002 (interview, clinical and laboratory data) were conducted in nationally representative samples>or=18 years old. Responses were received from 127,420 of 200,000 households (64%, representing 211,097 adults) for SHIELD, and 4257 participants for NHANES. Prevalence of diabetes mellitus, hypertension and dyslipidaemia was estimated within BMI categories, as was distribution of BMI levels among individuals with these diseases. Mean BMI was 27.8 kg/m2 for SHIELD and 27.9 kg/m2 for NHANES. Increased BMI was associated with increased prevalence of diabetes mellitus, hypertension and dyslipidaemia in both studies (p<0.001). For each condition, approximately [corrected] 75% or more [corrected] of patients had BMI>or=25 kg/m2. Estimated prevalence of diabetes mellitus and hypertension was similar in both studies, while dyslipidaemia was substantially higher in NHANES than SHIELD. In both studies, prevalence of diabetes mellitus, hypertension and dyslipidaemia occurred across all ranges of BMI, but increased with higher BMI. However, not all overweight or obese patients had these metabolic diseases and not all with these conditions were overweight or obese. Except for dyslipidaemia prevalence, SHIELD was comparable with NHANES. Consumer panel surveys may be an alternative method to collect data on the relationship of BMI and metabolic diseases.

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    • "Chen et al., for example, have built a predictive aging model of adolescent development [7]. Bays et al. have analyzed connections between body mass index and metabolic diseases [8]. These promising results have propelled our use of NHANES data to support our population-based study. "
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    ABSTRACT: Randomized controlled trials generate high-quality medical evidence. However, the use of unjustified inclusion/exclusion criteria may compromise the external validity of a study. We have introduced a method to assess the population representativeness of related clinical trials using electronic health record (EHR) data. As EHR data may not perfectly represent the real-world patient population, in this work, we further validated the method and its results using the National Health and Nutrition Examination Survey (NHANES) data. We visualized and quantified the differences in the distributions of age, HbA1c, and BMI among the target population of Type 2 diabetes trials, diabetics in NHANES databases, and a convenience sample of patients enrolled in selected Type 2 diabetes trials. The results are consistent with the previous study.
    Studies in health technology and informatics 08/2015; 216:569-73. DOI:10.3233/978-1-61499-564-7-569
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    • "It is valuable in monitoring unilateral kidney disease through comparison with the other, compensatory increased side [16]. As well, an increased BMI (25 kg/m 2 ) has been associated with increased prevalence of diabetes mellitus, hypertension and dyslipidaemia [10]. The impact of diabetes in renal system also could be appeared as a change in cortical echogenesity and thickness in case of diabetic nephropathy relative to normal ones that have been mentioned by Benjamin et al, [17] in which they found that: the kidney lengths were 12.4 ±0.9 cm for men and 11.6± 1.1 cm for women, and kidney volumes were 202 ± 36 ml for men and 154 ± 33 ml for women. "
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    ABSTRACT: A total sample size consists of 150 Diabetic male patients have been investigated by ultrasound system General Electric using gray-scale B-mode imaging with curvilinear transducer 3 MHz to assess the impact of diabetes in kidney morphology and it is distribution in Sudan. The collected data were the patient age, height, weight, kidneys size, ultrasound findings of involved kidneys, and duration of diabetes and residence region. The analyzed data showed that: the diabetes has been as endemic disease in central Sudan (Khartoum & Jazeera) representing 55% and in the west of Sudan representing 38%. The BMI of diabetic patients have been significantly (R2=0.6) decreasing following aging. The kidney size increases significantly as R2= 0.75 and 0.6 for left and right kidney respectively and their correlation fitted in the following equations: y = 3.95x + 27.26 and y = 2.41x + 35.12 for the left and right kidney respectively. The impact of duration was a reduction in size significantly as R2= 0.61 and 0.55 with a correlation fitted in the following equations: y = -2.22x + 139.9 and y = -1.51x + 96.59 for the left and right kidney respectively. The mean kidney length was enlarged (14.5 cm) and enlarged renal cortex in the range of 2-2.3 cm, enlarged kidneys size were 92.4 ± 11.7 and 121 ± 17.1 for the right and left kidney respectively and atrophied medulla while in late case the kidney is more echogenic, atrophied size with loss of corticomedullary differentiation.
    International Journal of Science and Research (IJSR) 10/2014; 3(10):2453-2457. DOI:10.4236/ojrad.2014.44039
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    • "Individuals who are overweight or obese are at a higher risk for developing type 2 diabetes. For example, Bays et al. (2007) reported that ''patients with higher BMI are at higher risk for having diabetes mellitus, hypertension, and dyslipidaemia…[and] the majority of patients with these metabolic diseases are either overweight or obese'' (p. 743). "
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    ABSTRACT: Prior studies have demonstrated an association between retrospective reports of experiencing trauma in childhood and the current incidence of type 2 diabetes in adulthood. Much less is known about this association among low-income minority patients in primary care settings. We replicated the adverse childhood experiences (ACEs) Centers for disease control and prevention (CDC) study with a low-income minority sample of primary care patients (N = 801) at a community-based healthcare center. We conducted a cross-sectional retrospective quantitative survey study to examine the association between participants’ reports of past childhood trauma and their current health care outcomes. Data were analyzed using binary logistic regression to evaluate the hypothesis that low income minority patients who reported more childhood trauma (abuse, neglect, household dysfunction, cumulative adverse childhood experiences [ACEs]) would more likely be diagnosed with type 2 diabetes. Results suggest that the number of ACEs in our sample were considerably higher than the original CDC ACEs study, as almost 50 % of patients surveyed at our clinic reported 4 or more ACEs, confirming that trauma is central in our urban primary care setting. The results of the cumulative ACEs score was in the expected direction and was significant, suggesting that participants who cumulatively reported experiencing more childhood trauma were more likely to be diagnosed with type 2 diabetes in adulthood. These findings have implications for family therapists, primary care providers, researchers, and policy makers to develop more collaborative approaches to primary care that better target the negative sequelae of ACEs.
    Contemporary Family Therapy 12/2013; 35(4). DOI:10.1007/s10591-013-9262-6
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