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    ABSTRACT: Physical activity (PA) and hypertension (HTN) are important influences on the development of type 2 diabetes (T2D). However, the joint impact of PA and HTN on T2D development is unknown. Two community-based prospective cohort studies, with the same protocols, instruments and questionnaires, were conducted among adults in urban areas of Nanjing, China, during 2004-2007 and 2007-2010. T2D was defined using World Health Organization criteria based on physicians' diagnosis and fasting blood glucose concentration. PA level (sufficient/insufficient) and blood pressure status (hypertensive/normotensive) were assessed at baseline and the third year of follow-up. We pooled and analyzed data from these two studies. Among 4550 participants aged 35 years or older, the three-year cumulative incidence of T2D was 5.1%. After adjusting for potential confounders, participants with sufficient PA were less likely to develop T2D than those with insufficient PA (OR = 0.43, 95%CI = 0.27, 0.68) and those who were normotensive were less likely to develop T2D than those who were hypertensive (OR = 0.39, 95%CI = 0.29, 0.51). Compared to participants with insufficient PA and who were hypertensive, those with sufficient PA and hypertension were at lower risk of developing T2D (OR = 0.36, 95%CI = 0.19, 0.69), as were those with insufficient PA who were normotensive (OR = 0.37, 95%CI = 0.28, 0.50) and those with sufficient PA who were normotensive (OR = 0.19, 95%CI = 0.10, 0.37). Insufficient PA was found to be associated with the development of T2D among adults with and without hypertension. These findings support a role for promoting higher physical activity levels to lower T2D risk in both hypertensive and non-hypertensive individuals.
    Full-text · Article · Feb 2014 · PLoS ONE
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    ABSTRACT: This study examined the prevalence and association of diabetes mellitus (DM) and prediabetes with cardiovascular risk factors among Puerto Ricans adults. Data from a household survey of 857 adults aged 21-79 years who underwent interviews, physical exams, and blood draws were analyzed. Prevalence of total DM and prediabetes was estimated using American Diabetes Association diagnostic criteria of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). Poisson regression models were used to estimate the prevalence ratio for each cardiovascular risk factor under study. Age-standardized prevalence of total DM and prediabetes, detected by FPG and/or HbA1c, was 25.5 and 47.4 %, respectively. Compared with participants with normoglycemia, those with previously diagnosed DM, undiagnosed DM, and prediabetes had more adverse cardiovascular risk factor profiles, characterized by a higher prevalence of general and abdominal obesity, hypertension, low HDL cholesterol, elevated LDL cholesterol, elevated triglycerides, and elevated plasminogen activator inhibitor 1 (p < 0.05). The high prevalence of DM and prediabetes calls for public health actions to plan and implement lifestyle interventions to prevent or delay the onset of DM and cardiovascular disease.
    Full-text · Article · Apr 2014 · Journal of Immigrant and Minority Health
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    ABSTRACT: Objective To examine the differences in 24-hour urine composition between patients with and without diabetes mellitus (DM) in a large cohort of stone formers.To examine differences in stone composition between patients with and without DM.Patients and MethodsA retrospective review of 1117 patients with nephrolithiasis and a 24-hour urinalysis was completed.Univariable analysis of 24-hour urine profiles and multivariable linear regression models were performed, comparing patients with and without DM.A subanalysis of patients with stone analysis data available was performed, comparing the stone composition of patients with and without DM.ResultsOf the 1117 patients who comprised the study population, 181 (16%) had DM and 936 (84%) did not have DM at the time of urinalysis.Univariable analysis demonstrated significantly higher total urine volume, citrate, UA, sodium, potassium, sulfate, oxalate, chloride, and supersaturation (SS) of UA in individuals with DM (all p<0.05). However, DM patients had significantly lower SS of calcium phosphate (CaP) and pH (all p<0.05).Multivariable analysis showed that patients with DM had significantly lower urinary pH and SS CaP, but significantly greater citrate, UA, sulfate, oxalate, chloride, SS UA, SS calcium oxalate, and volume than patients without DM (all p<0.05).Patients with DM had a significantly greater proportion of uric acid in their stones than patients without DM (50.2% vs. 13.5%, p<0.001).ConclusionsDM was associated with multiple differences on 24-hour urinalysis compared to those without DM, including significantly higher UA and oxalate, and lower pH.Control of urinary UA and pH, as well as limiting intake of dietary oxalate may reduce stone formation in patients with diabetes.
    No preview · Article · May 2014 · BJU International
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