ABSTRACT: To estimate the prevalence and type 2 diabetes, and to develop a prognostic model for identifying individuals at high risk of undiagnosed type 2 diabetes.
The study was designed as a cross-sectional investigation with 4314 participants of Thai background, aged between 15 and 85 years (mean age: 48). Fasting plasma glucose was initially measured, and repeated if the first measurement was more than 126 mg/dl. Type 2 diabetes was diagnosed using the World Health Organization's criteria. Logistic regression model was used to develop prognostic models for men and women separately. The prognostic performance of the model was assessed by the area under the receiver operating characteristic curve (AUC) and a nomogram was constructed from the logistic regression model.
The overall prevalence of type 2 diabetes was 7.4% (n = 125/1693) in men and 3.4% (n = 98/2621) in women. In either gender, the prevalence increased with age and body mass index (BMI). Gender, age, BMI and systolic blood pressure (SBP) were independently associated with type 2 diabetes risk. Based on the estimated parameters of model, a nomogram was constructed for predicting diabetes separated by gender. The AUC for the model with 3 factors was 0.75.
These data suggest that the combination of age, BMI and systolic blood pressure could help identify Thai individuals at high risk of undiagnosed diabetes.
Diabetes research and clinical practice 08/2011; 94(2):193-8. · 2.16 Impact Factor
ABSTRACT: The present study evaluated the diagnostic performance of Khon Kaen Osteoporosis Study (KKOS) score in identifying osteoporosis in men.
This was a cross-sectional investigation in 230 men aged > or = 50 years. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine by DXA (DPX-IQ densitometer LUNAR Corporation, Madison, Wisconsin, USA). The KKOS score was calculated for each man using his age and weight. Men with KKOS scores < or = -1 and > -1 were classified as "high risk" and "low risk", respectively.
The prevalence of osteoporosis in the entire sample was 17% and 7.4% (n = 39, 17) by femoral neck BMD and lumbar spine BMD, respectively. Using the KKOS score, 80 (34.8%) men were classified as "high risk" (KKOS score < or = -1). The proportion of high risk individuals increased with advancing age, ranging from 16.2% in the 50-65 age group to 64.8% in the > 65 age group. Using BMD from DXA as a gold standard, the overall sensitivity and specificity of KKOS in identifying osteoporosis was 72.5% and 73.2%, respectively. However; the sensitivity was higher at the lumbar spine (94.1% vs. 71.8%) than the femoral neck, while the specificity was comparable. The PPV of KKOS was 36%; and was lower at the lumbar spine (20%) compared to the femoral neck (35%). In the present study, men were classified "high risk" from KKOS, the risk (odds ratio; OR) of osteoporosis at the femoral neck and/or lumbar spine was 7.19 (95% CI: 3.34-15.44). However, the risk of osteoporosis was higher in the younger age (50-65 yr) group (OR: 10.29, 95% CI: 3.31-31.94) compared with the older age (> 65 yr) group (OR: 3.65, 95% CI: 1.12-11.91).
KKOS scoring system based on age and body weight, is a simple tool for clinicians to make a decision to further DXA testing for identifying osteoporosis in Thai men. This tool had a high sensitivity and specificity, but modest PPV.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 08/2007; 90(8):1518-23.
ABSTRACT: Although the prevalence of the metabolic syndrome (MetS) has been well-documented in Western Caucasian populations, there are few studies in non-Caucasian populations. The objectives of the present study were to estimate the prevalence of MetS and to find an optimal BMI cut-off value for defining obesity in the Thai population.
A sample of 307 men and 295 healthy women aged between 20 and 90 years (average age of 45 years) who came for a health check-up clinic in Khon Kaen, a northeast province of Thailand, were studied. The present study was conducted between 2003 and 2004. The modified ATP III criteria were used to estimate the age-and-sex specific prevalence of MetS, in which a BMI of > or = 27 kg/m(2) for men and 25 kg/m(2) for women were used in place of waist circumference. In the Thai population, these BMI cut-offs were equivalent to a percent body fat of 25% and 35% in men and women respectively.
The overall prevalence of MetS was 15%, with no significant differences between men (15.3%) and women (14.6%). In men, the prevalence increased from 9.5% among the 20-39 age group to 24.7% among the 50+ age groups. In women, the respective prevalence was 7% and 29.5%. When BMI was removed from the classification ofMetS, the overall prevalence of "MetS-without-BMI" (still defined by the presence of at least 3 abnormalities) in both men and women was 7.8%. However the prevalence of MetS-without-BMI increased with higher BMI levels: among those with BMI < 25, the prevalence was 4.6% in men and 5.0% in women; among those with BMI > or = 25, the prevalence was 13% in men and 16% in women.
The prevalence of MetS in this semi-rural Thai population was 15%, which is as common as in Caucasian populations. In the Thai population, obesity was a major component of MetS.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 04/2007; 90(3):459-67.
ABSTRACT: Determine the association between waist circumference (WC) and percentage body fat (%BF) and to develop cut-off values and evaluate the accuracy of WC in the definition of obesity in rural Thai population.
A cross-sectional, epidemiologic study in 181 men and 255 women aged 50+/-16 yr (mean+/-SD; range: 20-84 yr) sampled by stratified clustering sampling method, was designed. Percentage body fat was measured by dual energy X-ray absorptiometry (GE Lunar Corp, Madison, WI). The "golden standard"for defining obesity was%BF > or = 25 in men and%BF > or = 35 in women. Waist circumference in centimeter was measured.
In this study, the %BF-based prevalence of obesity in men and women was 8.3% and 44%, respectively. However using the WC cut-off (WHO) of 102 cm in men and 88 cm in women, only 1.7% of men and 24% of women were classified as obese. WC was a significant predictor of %BF, such that in men, a WC of 93 cm would predict a %BF of25%, and in women a WC of 84 cm would correspond to a %BF of 35%. The area under the receiver operating characteristic curve was 0. 87 and 0. 88 in men and women, respectively. In conclusion, waist circumference is a reasonably useful indicator of obesity.
The cut-off values of WC for diagnosing obesity should be lower in Thailand than in Western countries.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 11/2006; 89(10):1592-600.