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Abstract
There is limited information about the relationship between diabetes mellitus (DM)
and ALT to HDL-C ratio. This study aims to investigate this relationship for the first
time in Iran. The data of this study were taken from the third phase of the Shahroud
Eye Cohort Study, which was conducted in 2019 with the participation of 4394 people
aged 50–74. ALT and HDL-C levels were measured using a BT-1500 autoanalyzer. The mean
ALT/HDL-C ratio was reported along with 95% confidence intervals (CI). The multiple
logistic regression was used to examine the association between this ratio and DM,
while controlling for the effects of other independent variables. The mean and standard
deviation of the ALT/HDL-C ratio in all participants were 16.62 ± 11.22 (95% CI 16.28–16.96).
The prevalence of DM was 34.7% and individuals with DM had a mean ALT/HDL-C ratio
that was 1.80 units higher than those without diabetes (
P < 0.001). Also, in individuals with DM, the HDL-C was found to be 0.035 (mmol/L)
lower (
P < 0.001), while ALT was 1.13 (IU/L) higher (
P < 0.001) compared to those without diabetes. Additionally, after controlling for
confounding factors, the odds of developing DM increased in a non-linear manner with
an increase in the ALT/HDL-C ratio. Abdominal obesity, advanced age, female gender,
and hypertension were also found to be associated with increased odds of DM. In conclusion,
an increase in the ALT/ HDL-C ratiowas associated with higher odds of DM. This ratio
can serve as an important predictor for diabetes mellitus.
Summary Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding Bill & Melinda Gates Foundation.
A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.
[1
]Student Research Committee, Shahroud University of Medical Sciences, (
https://ror.org/023crty50)
Shahroud, Iran
[2
]Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences,
(
https://ror.org/023crty50)
Shahroud, Iran
[3
]Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, (
https://ror.org/00r1hxj45)
Tehran, Iran
[4
]Department of Epidemiology and Biostatistics, School of Public Health, Tehran University
of Medical Sciences, (
https://ror.org/01c4pz451)
Tehran, Iran
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History
Date
received
: 4
December
2023
Date
accepted
: 18
April
2024
Funding
Funded by: FundRef http://dx.doi.org/10.13039/501100004305, Shahroud University of Medical Sciences;
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