Raimund Pechlaner’s research while affiliated with Innsbruck Medical University and other places

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Publications (84)


Prediabetes and diabetes mellitus type II after ischemic stroke
  • Article

January 2025

European Stroke Journal

Kurt Moelgg

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Lukas Scherer

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Lukas Mayer-Suess

Introduction The progression of diabetes status in post-stroke patients remains under-investigated, particularly regarding new treatments for type II diabetes mellitus (DM II), like glucagon-like peptide 1 receptor agonists (GLP-1-RA) and sodium-glucose co-transporter-2 (SGLT-2) inhibitors, which have not been studied in the post-stroke setting. Patients and methods Eight hundred eighty-four consecutive ischemic stroke patients recruited to our prospective STROKE-CARD Registry were assessed concerning their glycemic status at baseline (normoglycemia, prediabetes, DM II) and change over time within 1 year follow-up. Multivariate logistic regression was performed to identify factors associated with transitioning from normoglycemia to prediabetes or DM II. Additionally, we reviewed ongoing clinical trials for GLP-1-RA and SGLT-2 inhibitors in the context of acute ischemic stroke. Results At baseline, 44.6% ( n = 394) of individuals had normoglycemia, 33.9% ( n = 300) were prediabetic, and 21.5% had DM II ( n = 190). After 1 year, normoglycemia decreased by 12.1 percentage points ( n = 107), whereas prediabetes and DM II increased by 10.2 percentage ( n = 90) points and 1.9 percentage points ( n = 17), respectively. Statin therapy was the only significant risk factor for progression. 23.4% ( n = 207) of our cohort would have met eligibility criteria for a recent trial on semaglutide in obese non-diabetics with prior cardiovascular disease. However, only one ongoing trial aims at evaluating short-term cardiovascular risk reduction in stroke patients. Discussion GPrediabetes and DM II are frequent in ischemic stroke patients. Even within an intensified post-stroke disease management setting, a considerable amount of stroke survivors convert to prediabetes or DM II within the first year. Our results demonstrate a notable proportion of patients qualifying inclusion in studies examining the efficacy of GLP-1-RA agonists and SGLT-2 inhibitors in secondary prevention. Conclusion Given the high prevalence and progression of prediabetes and DM II in stroke survivors, there is a need for clinical trials evaluating the use of GLP-1-RA and SGLT-2 inhibitors in this population.


Cervical Artery Tortuosity Is Associated With Dissection Occurrence and Late Recurrence: A Nested Case-Control Study

December 2024

Stroke

BACKGROUND The pathogenesis of spontaneous cervical artery dissection remains unclear, and no established predictors of recurrence exist. Our goal was to investigate the potential association between cervical artery tortuosity, a characteristic of patients with connective tissue disorder, and spontaneous cervical artery dissection. METHODS The ReSect study (Risk Factors for Recurrent Cervical Artery Dissection) is an observational study that invited all spontaneous cervical artery dissection patients treated at the Innsbruck University Hospital between 1996 and 2018 for clinical and radiological follow-up. Internal carotid and vertebral artery tortuosity was assessed on magnetic resonance angiography using a validated 3-dimensional algorithm. Differences between patients and healthy controls as well as dependent on recurrence status were assessed by applying χ ² , Mann-Whitney U test, and Kruskal-Wallis test where applicable, and confounders were established by bivariable Pearson correlation. Logistic regression was used to address the impact of tortuosity on dissection occurrence and recurrence as well as its association to extracellular matrix proteome data derived from skin biopsies in a subset of patients. RESULTS Magnetic resonance angiography was performed a median of 6.5 years after dissection in the included dissection patients. Patients with dissection (n=125) had significantly increased values of internal carotid artery tortuosity compared with healthy controls (n=24; odds ratio, 2.65 [95% CI, 1.68–3.86], 1 SD increase; P <0.01). This was also true for patients with long-term dissection recurrence (n=7) when compared with those with single time-point dissection (n=118; odds ratio, 2.00 [95% CI, 1.47–3.99], 1 SD increase; P <0.01). In patients with dissection and available extracellular matrix protein data (n=37), 6 of 13 (46.2%) proteins previously found linked with dissection recurrence were also associated with increased tortuosity. All 3 proteins associated with both anterior and posterior circulation tortuosity belonged to the desmosome-related cluster. CONCLUSIONS Internal carotid artery tortuosity is elevated in spontaneous cervical artery dissection patients compared with healthy controls, and this difference is most pronounced if individuals suffer from long-term dissection recurrence. Additionally, an association between tortuosity, being a readily measurable biomarker in routine magnetic resonance angiography, and proteomic markers of dissection recurrence exists, further enhancing the prospect of underlying subclinical connective tissue disease in dissection patients.


Study flowchart.
Proportion of post‐stroke fatigue in patients with dysphagia after stroke.
Dysphagia increases the risk of post‐stroke fatigue
  • Article
  • Full-text available

December 2024

Background Post‐stroke dysphagia is known to have a pronounced effect on mortality and quality of life of stroke patients. Here, we investigate whether this extends to post‐stroke fatigue, a major contributor to morbidity after ischemic stroke. Methods Patients with acute ischemic stroke (recruited consecutively in the STROKE‐CARD Registry from 2020 to 2023 at the study center Innsbruck, Austria) were examined for dysphagia via clinical swallowing examination at hospital admission. Post‐stroke fatigue was assessed using the Fatigue Severity Scale (FSS) at study specific in person follow‐up visits within the first year after ischemic stroke. Results Among 882 ischemic stroke patients (mean age 72.4 ± 13.5 years, 36.8% females), dysphagia was present in 22.0% at hospital admission and persisted in 16.2% until hospital discharge. Post‐stroke fatigue affected 52.2% of the total cohort during follow‐up and was significantly more prevalent among those with dysphagia (68.4% vs. 49.0%, p < 0.001). The prevalence of fatigue increased with the severity of dysphagia, with the highest proportion (86.7%) in those with severe dysphagia. After multivariable adjustment for other factors associated with post‐stroke fatigue, including age, sex, pre‐stroke disability, cognitive impairment, stroke severity, inability to walk at discharge, and need for antidepressants at discharge, dysphagia remained independently associated with post‐stroke fatigue during the first year after stroke (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.22–3.38). Conclusions Dysphagia is common after ischemic stroke and increases the risk of post‐stroke fatigue. Patient‐tailored measures are warranted to reduce fatigue after stroke and therefore enhance quality of life.

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Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

November 2024

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22 Citations

The Lancet

Background Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. Methods We used data from 1108 population-representative studies with 141 million participants aged 18 years and older with measurements of fasting glucose and glycated haemoglobin (HbA1c), and information on diabetes treatment. We defined diabetes as having a fasting plasma glucose (FPG) of 7·0 mmol/L or higher, having an HbA1c of 6·5% or higher, or taking medication for diabetes. We defined diabetes treatment as the proportion of people with diabetes who were taking medication for diabetes. We analysed the data in a Bayesian hierarchical meta-regression model to estimate diabetes prevalence and treatment. Findings In 2022, an estimated 828 million (95% credible interval [CrI] 757–908) adults (those aged 18 years and older) had diabetes, an increase of 630 million (554–713) from 1990. From 1990 to 2022, the age-standardised prevalence of diabetes increased in 131 countries for women and in 155 countries for men with a posterior probability of more than 0·80. The largest increases were in low-income and middle-income countries in southeast Asia (eg, Malaysia), south Asia (eg, Pakistan), the Middle East and north Africa (eg, Egypt), and Latin America and the Caribbean (eg, Jamaica, Trinidad and Tobago, and Costa Rica). Age-standardised prevalence neither increased nor decreased with a posterior probability of more than 0·80 in some countries in western and central Europe, sub-Saharan Africa, east Asia and the Pacific, Canada, and some Pacific island nations where prevalence was already high in 1990; it decreased with a posterior probability of more than 0·80 in women in Japan, Spain, and France, and in men in Nauru. The lowest prevalence in the world in 2022 was in western Europe and east Africa for both sexes, and in Japan and Canada for women, and the highest prevalence in the world in 2022 was in countries in Polynesia and Micronesia, some countries in the Caribbean and the Middle East and north Africa, as well as Pakistan and Malaysia. In 2022, 445 million (95% CrI 401–496) adults aged 30 years or older with diabetes did not receive treatment (59% of adults aged 30 years or older with diabetes), 3·5 times the number in 1990. From 1990 to 2022, diabetes treatment coverage increased in 118 countries for women and 98 countries for men with a posterior probability of more than 0·80. The largest improvement in treatment coverage was in some countries from central and western Europe and Latin America (Mexico, Colombia, Chile, and Costa Rica), Canada, South Korea, Russia, Seychelles, and Jordan. There was no increase in treatment coverage in most countries in sub-Saharan Africa; the Caribbean; Pacific island nations; and south, southeast, and central Asia. In 2022, age-standardised treatment coverage was lowest in countries in sub-Saharan Africa and south Asia, and treatment coverage was less than 10% in some African countries. Treatment coverage was 55% or higher in South Korea, many high-income western countries, and some countries in central and eastern Europe (eg, Poland, Czechia, and Russia), Latin America (eg, Costa Rica, Chile, and Mexico), and the Middle East and north Africa (eg, Jordan, Qatar, and Kuwait). Interpretation In most countries, especially in low-income and middle-income countries, diabetes treatment has not increased at all or has not increased sufficiently in comparison with the rise in prevalence. The burden of diabetes and untreated diabetes is increasingly borne by low-income and middle-income countries. The expansion of health insurance and primary health care should be accompanied with diabetes programmes that realign and resource health services to enhance the early detection and effective treatment of diabetes.


Intensified post-stroke care improves long-term dysphagia recovery after acute ischemic stroke: Results from the STROKE CARD trial

October 2024

European Stroke Journal

Introduction Dysphagia is common after acute ischemic stroke and entails considerable morbidity and mortality. Here, we investigated the impact of intensified care on swallowing recovery after stroke. Patients and methods In this secondary analysis of STROKE-CARD, a randomized intervention trial of intensified post-stroke care, dysphagia was assessed by speech therapists at admission for acute ischemic stroke, at hospital discharge, and after 12-months. Patients randomized to STROKE-CARD care additionally received a detailed dysphagia follow-up at 3-months, including a standardized dysphagia examination, instructions on further exercises and compensation mechanisms and, if necessary, referral for further speech therapy. Results Dysphagia was present initially after stroke in 236 (16.6%; median age 82 (73–88), 44.1% female) of 1419 patients, with similar prevalence in both study groups at hospital admission ( p = 0.239) and discharge ( p = 0.870). At follow up, 14 (9.5%) of 147 in the intervention group and 18 (20.2%) of 89 in the control group suffered from persistent dysphagia ( p = 0.020). There was better dysphagia recovery in the intervention group also under multivariable adjustment for age, sex, functional disability at 12-months, severe dysphagia at hospitalization, mode of feeding, cognitive impairment, thrombolysis, and stroke localization (odds ratio, 0.41, 95% confidence interval: 0.17 to 0.96). Discussion and conclusion Intensified post-stroke care improved dysphagia recovery within 1 year after acute ischemic stroke, highlighting the potential of targeted interventions for enhancing stroke outcomes.


Comorbidities associated with dysphagia after acute ischemic stroke

BMC Neurology

Background Pre-existing comorbidities increase the likelihood of post-stroke dysphagia. This study investigates comorbidity prevalence in patients with dysphagia after ischemic stroke. Methods The data of patients with acute ischemic stroke from two large representative cohorts (STROKE-CARD trial 2014–2019 and STROKE-CARD registry 2020–2022 – both study center Innsbruck, Austria) were analyzed for the presence of dysphagia at hospital admission (clinical swallowing examination). Comorbidities were assessed using the Charlson Comorbidity Index (CCI). Results Of 2054 patients with ischemic stroke, 17.2% showed dysphagia at hospital admission. Patients with dysphagia were older (77.8 ± 11.9 vs. 73.6 ± 14.3 years, p < 0.001), had more severe strokes (NIHSS 7(4–12) vs. 2(1–4), p < 0.001) and had higher CCI scores (4.7 ± 2.1 vs. 3.8 ± 2.0, p < 0.001) than those without swallowing impairment. Dysphagia correlated with hypertension (p = 0.034), atrial fibrillation (p < 0.001), diabetes (p = 0.002), non-smoking status (p = 0.014), myocardial infarction (p = 0.002), heart failure (p = 0.002), peripheral arterial disease (p < 0.001), severe chronic liver disease (p = 0.002) and kidney disease (p = 0.010). After adjusting for relevant factors, the associations with dysphagia remained significant for diabetes (p = 0.005), peripheral arterial disease (p = 0.007), kidney disease (p = 0.014), liver disease (p = 0.003) and overall CCI (p < 0.001). Conclusions Patients with multiple comorbidities have a higher risk of developing post-stroke dysphagia. Therefore, early and thorough screening for swallowing impairment after acute ischemic stroke is crucial especially in those with multiple concomitant diseases. Trial registration Stroke Card Registry (NCT04582825), Stroke Card Trial (NCT02156778).


Figure 1: Distributions of BMI and waist-to-height ratio, by region The black lines below each distribution show the 2·5%, 25·0%, 75·0%, and 97·5% quantiles of the distributions and the points show the median. The dashed lines show medians across all participants. Regions are ordered by their sex-specific median BMI. See appendix (p 55) for numerical summaries.
Figure 3: Regional BMI adjustment The BMI adjustment shows how much lower BMI in each region should be to achieve an equivalent waist-toheight ratio. The adjustment is shown relative to the population of the high-income western region where most current epidemiological studies have been done; regional ordering and differences across regions would be unchanged if a different reference were used. The bars show 95% CIs of the BMI adjustments. See appendix (pp 90-91) for results using waist circumference.
General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

August 2024

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6 Citations

The Lancet

Background Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.


Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

February 2024

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508 Citations

The Lancet

Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m²) and obesity (BMI ≥30 kg/m²). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.


Fig. 3 Graphic representation illustrating the differences in classification between body composition indices and BMI (created with https:// www. biore nder. com/)
Comparison of body mass index and fat mass index to classify body composition in adolescents-The EVA4YOU study

February 2024

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6 Citations

European Journal of Pediatrics

The objectives of this study were to develop age- and sex-specific reference percentiles for fat mass index (FMI) and fat-free mass index (FFMI) in adolescents aged 14 to 19 years and to determine differences in overweight/obesity classification by FMI and body mass index (BMI). The EVA4YOU study is a single-center cross-sectional study conducted in western Austria. Cardiovascular risks including anthropometric measurements and bioelectrical impedance analysis were assessed in adolescents (mean age 17 years). FMI and FFMI were calculated as the ratio of fat mass (FM) and fat-free mass (FFM) to the square of height and compared to study population–specific BMI percentiles. One thousand four hundred twenty-two adolescents were included in the analysis. Girls had a significantly higher mean FM and FMI and a significantly lower mean FFM, FFMI ( p < 0.001, each), and mean BMI ( p = 0.020) than boys. Body composition classification by FMI and BMI percentiles shows a concordance for the < 75th and > 97th percentile, but a significant difference in percentile rank classifications between these two cut-off values (all p < 0.05). Based on FMI, 15.5% (221/1422) of the whole population and 29.4% (92/313) of those between the 75th and 97th percentiles are classified one category higher or lower than those assigned by BMI. Conclusion : Classification of normal or pathologic body composition based on BMI and FMI shows good accordance in the clearly normal or pathologic range. In an intermediate range, FMI reclassifies categories based on BMI in more than a quarter of adolescents. Cut-off values to differentiate normal from pathologic FMI values on a biological basis are needed. Trial registration : The study is registered at www.clinicaltrials.gov (Identifier: NCT04598685; Date of registration: October 22, 2020). What is Known: • Chronic non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, with major risk factors including unhealthy diets, harmful behaviors, and obesity. Obesity in children and adolescents is a key risk factor for later NCDs, which is commonly measured by Body Mass Index (BMI). • BMI can be misleading as it doesn't distinguish between fat mass (FM) and fat-free mass (FFM), leading to potential misclassification of obesity in children. Previous studies have already suggested the use of the Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) as a more accurate measures of body composition. What is New: • This study adds the first age- and sex-specific reference values for FMI and FFMI in Austrian adolescents using bioelectrical impedance analysis (BIA) as a safe and secure measurement method of a large representative cohort. • We found percentile misclassification between BMI and FMI when categorizing for obesity, especially in intermediate categories of body composition. Furthermore, when comparing the new reference values for FMI and FFMI to existing ones from the US, UK, and Germany we could show a good alignment within the European cohorts and major differences with American values, indicating and confirming the difference of FMI and FFMI for different populations of different ethnical background, living on different continents.


Citations (62)


... Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The prevalence of diabetes has been rising globally, with an estimated 828 million adults affected in 2022 [1], while projections indicate a 25% increase by 2030 and a 51% increase by 2045, posing significant public health challenges [2]. Chronic hyperglycemia in diabetes is associated with the development of long-term complications, including cardiovascular diseases, nephropathy, retinopathy, neuropathy, ulceration, and secondary bacterial infection, all of which increase the risk of death in diabetic patients [3]. ...

Reference:

Exploring the Therapeutic Potential of Antibiotics in Hyperglycemia-Induced Macrophage Dysfunctions
Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

The Lancet

... However, the criteria for the Japanese population differ from the WHO criteria: the Japan Society for the Study of Obesity (JASSO) defines obesity as a BMI of 25 kg/m 2 or higher because the BMI associated with the lowest morbidity in the Japanese population is approximately 22 kg/m 2 [17], and the proportion of individuals with obesity (BMI of 30 or higher) is low in Japan [18]. This suggests that Asian populations may be more sensitive to body weight changes than Western populations [19][20][21][22][23]. A study showed that the Japanese BMI cut-off that is associated with cardiovascular risk factors is significantly lower than the American BMI cut-off [24]. ...

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

The Lancet

... Behavioral and lifestyle changes are considered a viable first-line treatment for diet-related noncommunicable diseases, including Type 2 Diabetes (T2D), prediabetes, hypertension, metabolic syndrome and obesity (1). The prevalence of these diseases is increasing, with 38% of adults in the United States having prediabetes or diabetes and 42% having obesity (2,3). The economic burden of metabolic disease is also high, with $412 billion spent on T2D and $173 billion on obesity annually in the form of direct care cost (4). ...

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

The Lancet

... This distinction is crucial, as studies have shown that FMI is a better predictor of metabolic and cardiovascular outcomes in pediatric populations compared to BMI. Emerging evidence suggests that FMI may more accurately reflect the relationship between body adiposity and CRF in children and adolescents [16,17]. ...

Comparison of body mass index and fat mass index to classify body composition in adolescents-The EVA4YOU study

European Journal of Pediatrics

... The EVA4YOU study is a single-center cross-sectional study, conducted between 01/02/2021 and 31/03/2023 at 57 schools and companies all over Tyrol, a state in western Austria with approximately 760 000 inhabitants, primarily of Caucasian descent [6,11,12]. We assessed the ...

Determinants of non-alcoholic fatty liver disease in young people: Maternal, neonatal, and adolescent factors

... It affects 21%-32% of stroke patients in the aftermath and is accompanied by reduced quality of life and increased short-term mortality [3][4][5][6][7][8]. Prior investigations have also linked dysphagia to psychosocial sequelae such as social isolation, anxiety, and depression, indicating a particular burden in everyday life of stroke survivors [5,9,10]. One psychosocial consequence of stroke and its association to dysphagia has previously been neglected: Nearly 50% of all stroke survivors develop post-stroke fatigue, which is considered to be a subjective feeling of mental and/or physical weakness or exhaustion not mitigated by rest [11,12]. ...

Association between dysphagia and symptoms of depression and anxiety after ischemic stroke

... The EVA4YOU study is a single-center cross-sectional study, conducted between 01/02/2021 and 31/03/2023 at 57 schools and companies all over Tyrol, a state in western Austria with approximately 760 000 inhabitants, primarily of Caucasian descent [6,11,12]. We assessed the ...

Determinants of Diet Quality in Adolescents: Results from the Prospective Population-Based EVA-Tyrol and EVA4YOU Cohorts

... The current MASLD diagnostic criteria of metabolic dysfunction include fasting blood glucose (FBG), a random blood glucose level over 11.1 mmol/L, and glycated hemoglobin (HbA1c) and plasma glucose measured 2 h after obtaining a 75 g glucose load using the oral glucose tolerance test (OGTT). However, individuals with irregular blood glucose levels may remain undiagnosed for T2DM due to normal fasting glucose levels, resulting in a concealed at-risk group that could be overlooked [8]. Emerging studies and the International Diabetes Federation support establishing 1-h post-glucose (1hPG) ≥155 mg/dL (8.6 mmol/L) as a reliable marker for predicting future diabetes and metabolic complications, such as MASLD. ...

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Nature Medicine

... Komarek et al conducted an extensive prospective study at Innsbruck University Hospital, Austria, involving 572 patients. 16 This research assessed both mRNA and adenovirus-vector vaccines, finding no significant association between COVID-19 vaccination and the incidence of stroke, thus offering reassurance about vaccine safety in the context of ischemic stroke. ...

No association between SARS-CoV-2 vaccination and ischaemic stroke or high-risk transient ischaemic attack
  • Citing Article
  • October 2023

Journal of the Neurological Sciences

... It has recently been shown that headache is the leading reported cause of school absenteeism among children and adolescents (7). Although the exact etiology of primary headache disorders among adolescents is not yet fully understood (8), several factors, such as age (7,9), sex (4,10,11), obesity, underweight (12), anxiety/depression (11,13,14), and sleep disorders (11,15) are associated with primary headache disorders among children and adolescents. Recent reports show varied primary headache disorders rates among adolescents in different countries (3,7,(9)(10)(11)16). ...

Early Vascular Ageing in adolescents with migraine with aura: a community-based study

BMC Cardiovascular Disorders