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Introduction: Obesity is well recognized to be an important risk factor for hypertension (HTN), but it is not clear which obesity indices have stronger association with HTN. Aim: To evaluate the ability of different obesity indices, including visceral adiposity index (VAI), hypertriglyceridemic-waist (HTGW) phenotype, a body shape index (ABSI), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) as possible hypertension (HTN) predictor in a high-risk population. Methods: Seven years follow-up data in first-degree relatives of consecutive patients with type 2 diabetes aged 30-70 years without diabetes and HTN with at least one follow-up examination (n = 1417) were analysed. Discriminatory capabilities were examined using the receiver operating characteristic (ROC) curve. Logistic regression analysis was performed to determine the strength of association between obesity indices and HTN. Results: Among the indices, the highest quintile compared with the lowest quintile of WHtR and WC was more strongly associated with HTN in age and sex adjusted models [odds ratio (95% CI); WHtR: 4.02 (2.36, 6.85) and WC: 3.26 (2.05, 5.20)]. Those with HTGW phenotype was 2.3 (1.54, 3.35) times more likely to develop HTN than those with normal WC normal triglyceride. On ROC curve analysis, WHtR (63.1%; 59.6, 66.7) and WC (61.7%, 58.0, 65.4) had the higher area under the ROC. Conclusions: Although higher values of VAI, BMI, WHR and HTGW were associated with the risk of HTN, WHtR and WC was more strongly associated with the development of HTN, while the ABSI showed weaker association. [ABSTRACT FROM AUTHOR]

Aims: Previous study has reported that triglycerides-glucose (TyG) index, a product of triglycerides and fasting plasma glucose (FPG), might be useful in the prediction of incident type 2 diabetes (T2D). We evaluated the ability of the TyG index compared to FPG and OGTT as possible diabetes predictor in nondiabetic first-degree relatives (FDRs) of patients with T2D. Methods: A total of 1,488 FDRs without diabetes of consecutive patients with T2D 30-70 years old (361 men and 1,127 women) were examined and followed for a mean (SD) of 6.9 (1.7) years for diabetes incidence. We examined the incidence of diabetes across quartiles of the TyG index and plotted a receiver operating characteristic (ROC) curve to assess discrimination. At baseline and through follow-up, participants underwent a standard 75-g two-hour oral glucose tolerance test. Results: During 10,124 person-years of follow-up, 41 men and 154 women developed T2D. Those in the top quartile of TyG index were 3.4 times more likely to develop T2D than those in the bottom quartile (odds ratio 3.36; 95 % CI 1.83, 6.19). On ROC curve analysis, a higher area under the ROC was found for FPG (76.2; 95 % CI 71.9, 80.6), 1-hPG (81.0, 95 % CI 77.2, 84.9) and 2-hPG (76.5; 95 % CI 72.3, 80.8) than for TyG index (65.1; 95 % CI 60.5, 69.7). Conclusions: TyG index is predicted T2D in high-risk individuals in Iran but FPG, 1-hPG and 2-hPG appeared to be more robust predictor of T2D in our study population. [ABSTRACT FROM AUTHOR]

The relation of early menarche with type 2 diabetes mellitus (T2DM) remains inconsistent across studies. The objective of this systematic review and meta-analysis of published population-based observational studies was to assess the association between age at menarche and T2DM risk. We searched online data bases through December 2013 and examined the reference lists of pertinent articles. Summary relative risks (RRs) with 95 % confidence intervals (CIs) were calculated with a random-effects model. A total of 14 effect estimates from 10 eligible studies (three cross-sectional and seven cohort studies) included 315,428 participants and 22,085 cases of T2DM. Compared with the highest or middle category, women in the lowest category of age at menarche had higher risk of T2DM [summary RR (95 % CI) 1.22 (1.17, 1.28)]. These results were consistent between studies that conducted in the United States and in Europe. The association between age at menarche and T2DM was slightly stronger for cohort than for cross-sectional studies. These findings strongly support an association between younger age at menarche and increased risk of T2DM. Age at menarche may help identify women with increased risk of developing T2DM. [ABSTRACT FROM AUTHOR]

The present systematic review and metaanalysis of published observational studies was conducted to assess the health effects of exposure to air pollution on diabetes risk. Online databases were searched through January 2013, and the reference lists of pertinent articles reporting observational studies in humans were examined. Pooled relative risks and 95 % confidence intervals were calculated with a random-effects model. Exposure to air pollution was associated with slight increase in risk of diabetes and susceptibility of people with diabetes to air pollution. These results were consistent between time-series, case-crossover and cohort studies and between studies conducted in North America and Europe. The association between exposure to air pollution and diabetes was stronger for gaseous pollutants than for particulate matter. Our metaanalysis suggests that exposure to air pollution may be a risk factor for diabetes and increase susceptibility of people with diabetes to air pollution. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effects of hip circumference (HC) and height on diabetes incidence in non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes. A total of 1,092 (254 men and 838 women) non-diabetics FDRs ≥ 30 years old in 2003-2005 were followed through 2010 for the occurrence of type 2 diabetes. At baseline and through follow-ups, participants were underwent a standard 75 g 2-h oral glucose tolerance test. The incidence of type 2 diabetes was 17.0 (95% CI: 13.7, 20.2) (13.0 men and 18.1 women) per 1,000 person-year based on 6,015 person-years of follow-up. Height was inversely associated with diabetes incidence. The age-, gender-, and waist-adjusted relative risk (95% CI) of diabetes was 0.54 (0.31, 0.93) for highest quartile of height and 0.59 (0.25, 1.37) for highest quartile of HC compared with lowest quartile. These data indicate that height was inversely associated with diabetes incidence, independently of gender among FDRs of patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the incidence of type 2 diabetes using newly proposed hemoglobin A (HbA) and current oral glucose tolerance test (OGTT) definition in an Iranian non-diabetic population. A total of 923 non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes 30-70 years old in 2003-2005 were followed through 2009 for the occurrence of type 2 diabetes. At baseline and through follow-ups, participants underwent a standard 75 g 2-h OGTT and HbA measurements. Prediction of progression to type 2 diabetes by OGTT-defined or HbA-defined diabetes was assessed with area under the receiver operating characteristic (ROC) curves based upon measurement of fasting plasma glucose, 2-h post-load glucose values, and HbA. The prevalence of type 2 diabetes was 9.2% (95% CI: 8.2, 10.2) by OGTT-defined diabetes and 7.9% (95% CI: 6.9, 9.0) by HbA ≥6.5. The incidence of type 2 diabetes was 2.0% (95% CI: 1.6, 2.4) (1.8% men and 2.1% women) per year by the current OGTT definition, whereas the incidence rates were 1.7% (95% CI: 1.3, 2.0) (1.6% men and 1.7% women) per year by HbA ≥6.5%. Of those diagnosed with type 2 diabetes by OGTT, 69.6% had HbA <6.5% and therefore would not have been classified as having type 2 diabetes. The incidence and prevalence of diabetes using newly proposed HbA threshold in this FDRs of patients with type 2 diabetes were slightly lower than using current OGTT definition. [ABSTRACT FROM AUTHOR]

Recent epidemiological studies suggest that treatment with insulin may promote cancer growth. The present systematic review and meta-analysis of published observational studies was conducted to assess the risk of cancer during treatment with insulin. A search of online database through January 2011 was performed and examined the reference lists of pertinent articles, limited to observational studies in humans. Pooled relative risks (RRs) and 95 % confidence intervals (CIs) were calculated with a random-effects model. Fifteen studies (five case-control and ten cohort studies) were included, with 562,043 participants and 14,085 cases of cancer. Insulin treatment was associated with an increased risk of overall cancer [summary RR (95 % CI) = 1.39 (1.14, 1.70)]. Summary RR (95 % CI) for case-control studies was 1.83 (0.99, 3.38), whereas RR for cohort studies was 1.28 (1.03, 1.59). These results were consistent between studies conducted in the USA and in Europe. For studies that included combined type 1 and 2 diabetes, the summary estimate was stronger than studies including only type 2 diabetes mellitus. The association between insulin treatment and cancer was stronger for pancreatic cancer [summary RR (95 % CI) = 4.78 (3.12, 7.32)] than for colorectal cancer [1.50 (1.08, 2.08)]. Insulin treatment was not associated with breast, prostate, and hepatocelluar cancer, and their effect estimates were not statistically significant. Our findings support an association between insulin use and increased risk of overall, pancreatic, and colorectal cancer. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the effect of additional magnesium sulfate (MgSO) 100 mg to intrathecal (IT) isobaric 0.5% bupivacaine 3 ml on spinal anesthesia in patients undergoing lower extremity orthopedic surgery. Methods: In a double-blind randomized clinical trial, 79 American Association of Anesthesiologists (ASA) I or II adult patients undergoing lower extremity orthopedic surgery were recruited. The patients were randomly allocated to receive 100 mg MgSO 5% (0.2 ml) plus 15 mg of bupivacaine 0.5% (MgSO group) or 15 mg bupivacaine 0.5% combined with 0.2 ml normal saline (control group) intrathecally. Response to treatment was assessed as onset and duration of sensory block, the highest level of sensory block, time to complete motor block recovery, duration of spinal anesthesia, and postoperative analgesic requirement. Results: The onset of the sensory block was slower in the MgSO group than in the control group (13.3 vs. 11.6 min, P = 0.04), and the duration of the sensory blockade was significantly longer in the MgSO group than the control group (106.5 vs. 85.5 min, P = 0.001). Total analgesic requirements for 24 h following surgery were lower in the MgSO group than in the control group (96.8 vs. 138.5 mg, P = 0.001). Mean duration of spinal anesthesia was not significantly different between two groups (178.0 vs. 167.4 min, P = 0.23). Conclusion: In patients undergoing lower extremity surgery with spinal anesthesia, the addition of 100 mg IT MgSO to 15 mg bupivacaine without opioid supplement, prolonged the duration of the sensory block, decreased postoperative analgesic consumption, and significantly prolonged the onset of spinal anesthesia. [ABSTRACT FROM AUTHOR]

The prevalence of sexual media use, and factors associated with it, among Chinese young adults were studied in Hong Kong. Questions on use of sexual media were asked as part of a youth sexuality study conducted by the Family Planning Association in 1996. In a population-based cross-sectional study, 517 men and 447 women aged 18-27 years completed an anonymous structured self-administered questionnaire. The overall prevalence [95% confidence interval (CI)] of ever purchased or rented any type of sexual media was 57.8% (54.7-60.9). More men (70.2%; 95% CI: 66.3-74.2) than women (43.4%; 95% CI: 38.8-48.0) used sexual media. Of 31 independent variables tested by stepwise logistic regression, seven variables significantly predicted sexual media use: age (adjusted odds ratio OR = 1.5 for 21-24 and 1.8 for 25-28, versus 20 or below), male gender (OR = 3.0), number of sexual partner (OR = 2.2 for one and 2.8 for two or more partners), masturbation in the past week (OR = 3.2), being out of school (OR = 1.5), quarrel with family member in past 6 months (OR = 1.8), and religion (OR = 1.6 for no religion and 3.4 for traditional Chinese religion, versus Christians) (all adjusted OR:p < 0.05). [ABSTRACT FROM AUTHOR]