Browsing by Subject "Risk Factors"
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Item COMPARISON OF BODY MASS INDEX PERCENTILE AND PERCENT BODY FAT ON RISK FACTORS FOR TYPE 2 DIABETES MELLITUS IN CHILDREN AGED 10-14(2014-03) Fernando, Shane I.; Fulda, Kimberly; Franks, Susan; Bowman, W. Paul; Shah, Deep; Proffitt-Leyva, Randi; Bawa, Binky; Habiba, NusrathThe growing rate of type 2 diabetes mellitus (T2DM) in children presents a critical public health problem for the future. However, assessment of T2DM risk among children can be challenging. Therefore, to improve assessment of risk, we examined the association between BMIP (body mass index percentile, a traditional indicator) with risk, compared to the association of percent body fat (PBF) with risk. Methods: Data were obtained from 290 10-14 year old adolescents who were patients in the pediatrics department of the University of North Texas Health Science Center, patients at Seminary Clinic in Fort Worth and recruited from community events. During study visits, subjects’ BMI percentile and percent body fat were obtained using standard height/weight measurements as well as through the use of a Tanita body composition device. Associations were then assessed using statistical regression models. Results: Among 290 subjects, 78.2% were of Hispanic origin, with approximately 13.4% being Black. Approximately 51% of subjects were female, while age distribution was evenly spread across 10-14. Logistic regression models found that both PBF and BMIP were significantly associated with Acanthosis nigricans (PBF: Sβ 0.584 vs. BMIP: Sβ 0.489), average systolic BP above 95th percentile (PBF: Sβ 0.219 vs. BMIP: Sβ 0.124), family history of T2DM (PBF: Sβ 0.189 vs. BMIP: Sβ 0.172), and high blood sugar test (PBF: Sβ 0.152 vs. BMIP: Sβ 0.119). Conclusions: The data from this study provides evidence that PBF may be a better measurement of T2DM risk among children compared to BMIP. It may be beneficial for pediatric and family physicians to measure PBF alongside BMIP to better ascertain a particular pediatric patient’s risk of T2DM. Purpose (a): The growing rate of type 2 diabetes mellitus (T2DM) in children presents a critical public health problem for the future. However, assessment of T2DM risk among children can be challenging. Therefore, to improve assessment of risk, we examined the association between BMIP (body mass index percentile, a traditional indicator) with risk, compared to the association of percent body fat (PBF) with risk. Methods (b): Data were obtained from 290 10-14 year olds in North Central Texas participating in a study examining risk for T2DM. During study visits, subjects’ BMI percentile and percent body fat were obtained using a Tanita body composition device. Associations were then assessed using logistic regression models against four of the five critical risk factors for T2DM: Average blood pressure (BP) above 95th percentile or History of high BP, family history of type 2 diabetes mellitus, positive sign of Acanthosis nigricans and a high blood sugar test. Results (c): Among 290 subjects, 78.2% were of Hispanic origin, with approximately 13.4% being Black. Approximately 51% of subjects were female, while age distribution was evenly spread across 10-14. Logistic regression models found that both PBF and BMIP were significantly associated with Acanthosis nigricans (PBF: Sβ 0.584 vs. BMIP: Sβ 0.489), average systolic BP above 95th percentile (PBF: Sβ 0.219 vs. BMIP: Sβ 0.124), family history of T2DM (PBF: Sβ 0.189 vs. BMIP: Sβ 0.172), and high blood sugar test (PBF: Sβ 0.152 vs. BMIP: Sβ 0.119). Conclusions (d): The data from this study provides evidence that PBF may be a better measurement of T2DM risk among children compared to BMIP. It may be beneficial for pediatric and family physicians to measure PBF alongside BMIP to better ascertain a particular pediatric patient’s risk of T2DM.Item Depression, inflammation, and memory loss among Mexican Americans: analysis of the HABLE cohort(Cambridge University Press, 2017-06-20) Johnson, Leigh A.; Edwards, Melissa; Gamboa, Adriana; Hall, James R.; Robinson, Michelle; O'Bryant, Sid E.Background: This study explored the combined impact of depression and inflammation on memory functioning among Mexican-American adults and elders. Methods: Data were analyzed from 381 participants of the Health and Aging Brain study among Latino Elders (HABLE). Fasting serum samples were collected and assayed in duplicate using electrochemiluminesce on the SECTOR Imager 2400A from Meso Scale Discovery. Positive DepE (depression endophenotype) was codified as any score >1 on a five-point scale based on the GDS-30. Inflammation was determined by TNFɑ levels and categorized by tertiles (1st, 2nd, 3rd). WMS-III LMI and LMII as well as CERAD were utilized as measures of memory. ANOVAs examined group differences between positive DepE and inflammation tertiles with neuropsychological scale scores as outcome variables. Logistic regressions were used to examine level of inflammation and DepE positive status on the risk for MCI. Results: Positive DepE as well as higher inflammation were both independently found to be associated with lower memory scores. Among DepE positive, those who were high in inflammation (3rd tertile) were found to perform significantly worse on WMS-III LM I (F = 4.75, p = 0.003), WMS-III LM II (F = 8.18, p < 0.001), and CERAD List Learning (F = 17.37, p < 0.001) when compared to those low on inflammation (1st tertile). The combination of DepE positive and highest tertile of inflammation was associated with increased risk for MCI diagnosis (OR = 6.06; 95% CI = 3.9-11.2, p < 0.001). Conclusion: Presence of elevated inflammation and positive DepE scores increased risk for worse memory among Mexican-American older adults. Additionally, the combination of DepE and high inflammation was associated with increased risk for MCI diagnosis. This work suggests that depression and inflammation are independently associated with worse memory among Mexican-American adults and elders; however, the combination of both increases risk for poorer memory beyond either alone.Item Does Diversity Matter? Disparities in Diagnostic Delays and Contralateral Risk Factors in Slipped Capital Femoral Epiphysis(2022-12) Purcell, Maureen W.; Reeves, Rustin E.; Mayfield, Matthew; Lovely, Rehana S.; Berg, Rance E.The skeletal pathology slipped capital femoral epiphysis (SCFE) is one of the more common hip diseases that can affect adolescents. Delays in diagnosis and the risk of contralateral SCFE are recognized issues for this patient population. However, SCFE studies often do not include the groups of people most often diagnosed with this pathology, namely Black and Hispanic individuals. This project aimed to address this literature gap by investigating the recognized issues with a sizeable sample of individuals in those ethnic groups, roughly equal to the White patient group. We found that the severity of SCFE measured by Southwick slip angle (SSA) is significantly associated with both insurance type and patient status. Patients who were covered by private insurance or were already an established patient at the medical center were more likely to be diagnosed with mild SCFE, and patients with no insurance had a significantly higher mean SSA than patients with insurance. Posterior sloping angle (PSA) and physeal sloping angle in the anterior-posterior view (PSA-AP) are two of the most often used measurements to estimate contralateral slip risk. They were not predictive of contralateral slip risk in our sample, except for PSA-AP in male patients. When analyzed within each ethnic subgroup, we found significant differences in the PSA and PSA-AP between males and females within the Hispanic patient sample only. This suggests that these angles are not necessarily predictive for all patients groups, and/or that there may be sex differences within patient populations that can affect the utility of these metrics. To the authors' knowledge, the above findings are the first to link SSA to insurance status and patient status, and to the first to analyze the PSA and PSA-AP angles of a Hispanic SCFE patient group.Item Hypermethylation at CREBBP Is Associated with Cognitive Impairment in a Mexican American Cohort(IOS Press, 2023-03-07) Abraham Daniel, Ann; Silzer, Talisa; Sun, Jie; Zhou, Zhengyang; Hall, Courtney; Phillips, Nicole; Barber, Robert C.BACKGROUND: The aging Mexican American (MA) population is the fastest growing ethnic minority group in the US. MAs have a unique metabolic-related risk for Alzheimer's disease (AD) and mild cognitive impairment (MCI), compared to non-Hispanic whites (NHW). This risk for cognitive impairment (CI) is multifactorial involving genetics, environmental, and lifestyle factors. Changes in environment and lifestyle can alter patterns and even possibly reverse derangement of DNA methylation (a form of epigenetic regulation). OBJECTIVE: We sought to identify ethnicity-specific DNA methylation profiles that may be associated with CI in MAs and NHWs. METHODS: DNA obtained from peripheral blood of 551 participants from the Texas Alzheimer's Research and Care Consortium was typed on the Illumina Infinium® MethylationEPIC chip array, which assesses over 850K CpG genomic sites. Within each ethnic group (N = 299 MAs, N = 252 NHWs), participants were stratified by cognitive status (control versus CI). Beta values, representing relative degree of methylation, were normalized using the Beta MIxture Quantile dilation method and assessed for differential methylation using the Chip Analysis Methylation Pipeline (ChAMP), limma and cate packages in R. RESULTS: Two differentially methylated sites were significant: cg13135255 (MAs) and cg27002303 (NHWs) based on an FDR p < 0.05. Three suggestive sites obtained were cg01887506 (MAs) and cg10607142 and cg13529380 (NHWs). Most methylation sites were hypermethylated in CI compared to controls, except cg13529380 which was hypomethylated. CONCLUSION: The strongest association with CI was at cg13135255 (FDR-adjusted p = 0.029 in MAs), within the CREBBP gene. Moving forward, identifying additional ethnicity-specific methylation sites may be useful to discern CI risk in MAs.Item Liver Biomarkers and Lipid Profiles in Mexican and Mexican-American 10- to 14-Year-Old Adolescents at Risk for Type 2 Diabetes(Hindawi, 2017-07-26) Fernández-Gaxiola, Ana Cecilia; Valdés-Ramos, Roxana; Fulda, Kimberly G.; López, Ana Laura Guadarrama; Martínez-Carrillo, Beatriz E.; Franks, Susan F.; Fernando, Shane I.Liver enzymes alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) are markers for type 2 diabetes mellitus (T2DM); alkaline phosphatase is a marker of liver disease. Mexican-American adolescents are disproportionately affected by T2DM, while in Mexico its prevalence is emerging. We assessed liver biomarkers and lipid profiles among Mexican and Mexican-American adolescents 10-14 years old with high/low risk of T2DM through a cross-sectional, descriptive study (Texas n = 144; Mexico n = 149). We included family medical histories, anthropometry, and blood pressure. Obesity was present in one-third of subjects in both sites. ALT (UL) was higher (p < 0.001) in high-risk adolescents (23.5 ± 19.5 versus 17.2 ± 13.4 for males, 19.7 ± 11.6 versus 15.1 ± 5.5 for females), in Toluca and in Texas (26.0 ± 14.7 versus 20.0 ± 13.2 for males, 18.2 ± 13.4 versus 14.6 ± 10.1 for females), as well as GGT (UL) (p < 0.001) (18.7 ± 11.1 versus 12.4 ± 2.3 for males, 13.6 ± 5.8 versus 11.5 ± 3.9 for Mexican females; 21.0 ± 6.8 versus 15.4 ± 5.5 for males, 14.3 ± 5.0 versus 13.8 ± 5.3 for females in Texas). We found no differences by sex or BMI. Total cholesterol and HDL were higher among Mexican-Americans (p < 0.001). In conclusion, multiple risk factors were present in the sample. We found differences by gender and between high and low risk for T2DM adolescents in all liver enzymes in both sites.Item Retrospective data analyses of social and environmental determinants of malaria control for elimination prospects in Eritrea(BioMed Central Ltd., 2020-03-12) Mihreteab, Selam; Lubinda, Jailos; Zhao, Bingxin; Rodriguez-Morales, Alfonso J.; Karamehic-Muratovic, Ajlina; Goitom, Aman; Shad, Mohammad Yousaf; Haque, UbydulBACKGROUND: The present study focuses on both long- and short-term malaria transmission in Eritrea and investigates the risk factors. Annual aggregates of information on malaria cases, deaths, diagnostics and control interventions from 2001 to 2008 and monthly reported data from 2009 to 2017 were obtained from the National Malaria Control Programme. We used a generalized linear regression model to examine the associations among total malaria cases, death, insecticide-treated net coverage, indoor residual spraying and climatic parameters. RESULTS: Reduction in malaria mortality is demonstrated by the milestone margins of over 97% by the end of 2017. Malaria incidence likewise declined during the period (from 33 to 5 per 1000 population), representing a reduction of about 86% (R(2) = 0.3) slightly less than the decline in mortality. The distribution of insecticide treated nets generally declined between 2001 and 2014 (R(2) = 0.16) before increasing from 2015 to 2017, while the number of people protected by indoor residual spraying slightly increased (R(2) = 0.27). Higher rainfall was significantly associated with an increased number of malaria cases. The covariates rainfall and temperature are a better pair than IRS and LLIN to predict incidences. On the other hand, IRS and LLIN is a more significant pair to predict mortality cases. CONCLUSIONS: While Eritrea has made significant progress towards malaria elimination, this progress should be maintained and further improved. Distribution, coverage and utilization of malaria control and elimination tools should be optimized and sustained to safeguard the gains made. Additionally, consistent annual performance evaluation of malaria indicators would ensure a continuous learning process from gains/threats of epidemics and resurgence in regions already earmarked for elimination.Item Risk of venous thromboembolism in knee, hip and hand osteoarthritis: a general population-based cohort study(2020-09-16) Zeng, Chao; Bennell, Kim; Yang, Zidan; Nguyen, Uyen-Sa D. T.; Lu, Na; Wei, Jie; Lei, Guanghua; Zhang, YuqingOBJECTIVES: Osteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator. METHODS: We conducted three cohort studies using data from The Health Improvement Network. Up to five individuals without osteoarthritis were matched to each case of incident knee (n=20 696), hip (n=10 411) or hand (n=6329) osteoarthritis by age, sex, entry time and body mass index. We examined the relation of osteoarthritis to VTE (pulmonary embolism and deep vein thrombosis) using a multivariable Cox proportional hazard model. RESULTS: VTE developed in 327 individuals with knee osteoarthritis and 951 individuals without osteoarthritis (2.7 vs 2.0 per 1000 person-years), with multivariable-adjusted HR being 1.38 (95% CI 1.23 to 1.56). The indirect effect (HR) of knee osteoarthritis on VTE through knee replacement was 1.07 (95% CI 1.01 to 1.15), explaining 24.8% of its total effect on VTE. Risk of VTE was higher in hip osteoarthritis than non-osteoarthritis (3.3 vs 1.8 per 1000 person-years; multivariable-adjusted HR=1.83, 95% CI 1.56 to 2.13). The indirect effect through hip replacement yielded an HR of 1.14 (95% CI 1.04 to 1.25), explaining 28.1% of the total effect. No statistically significant difference in VTE risk was observed between hand osteoarthritis and non-osteoarthritis (1.5 vs 1.6 per 1000 person-years; multivariable-adjusted HR=0.88, 95% CI 0.67 to 1.16). CONCLUSION: Our large population-based cohort study provides the first evidence that knee or hip osteoarthritis, but not hand osteoarthritis, was associated with an increased risk of VTE, and such an association was partially mediated through knee or hip replacement.Item The Risk Factors of High Blood Pressure among Young Adults in the Tujia-Nationality Settlement of China(Hindawi, 2017-08-28) Liu, Xiaoli; Xiang, Zheng; Shi, Xiangrong; Schenck, Hannah; Yi, Xinfeng; Ni, Rong; Liu, ChaonengDemographics questionnaires, and fitness tests were utilized to identify the risk factors of hypertension among younger adults in the years 2005, 2010, and 2014 in China's southwest province of Hubei. The results demonstrated that the prevalence of hypertension was higher between 2011 and 2014 among the young people in this area. The main risk factors of developing hypertension were found to be sex (as man), individuals over 40 years old, blue collar employees who worked in rural areas, overweight/obesity, and those with the low CRF.