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2. Agreement Between Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry to Estimate Fat Mass in Hispanic Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Author

Castillo Castro, Carolina, González Arellanes, Rogelio, Camacho Mondragón, Christian Giovanni, Farfán Esponda, Heriberto Raúl, del Razo Olvera, Fabiola Mabel, Aguilar Salinas, Carlos A, and Martagon, Alexandro J

Abstract

Background: Adipose tissue excess is associated with adverse health outcomes, including type 2 diabetes. Body mass index (BMI) is used to evaluate obesity but is inaccurate as it does not account for muscle mass, bone density, and fat distribution. Accurate measurement of adipose tissue through dual-energy X-ray absorptiometry (DXA) and computed axial tomography (CT) is crucial for managing and monitoring adiposity-related diseases. Still, these are not easily accessible in most hospitals in Mexico. Bioelectrical impedance analysis (BIA) is non-invasive and low-cost but may not be reliable in conditions affecting the body's hydration status, like diabetes. Objectives: To assess fat mass concordance between BIA and DXA in Hispanic-American adults with type 2 diabetes mellitus (T2DM). Methods: Cross-sectional study of a non-probabilistic sample of subjects over 18 years with type 2 diabetes. We used DXA as the reference method. Results: We evaluated the accuracy of FM estimation through BIA and DXA in 309 subjects with type 2 diabetes. Results showed a trend of overestimating the diagnosis of obesity using BIA, especially in individuals with a higher fat mass index (FMI). At the group level, we found BIA accurate; however, at the individual level, it is not. The bias between the 2 methods showed a statistically significant overestimation of body fat by BIA (P ⩽.01) in both sexes. BIA demonstrated high precision in estimating fat mass. We were able to provide a correction factor of 0.55 kg in men. Conclusion: BIA is inaccurate compared to DXA for body composition assessment in patients with diabetes. Inaccurate measurements can result in misclassification. However, BIA is precise for body composition assessment in patients with diabetes, so it is reliable for tracking patient progress over time. Plain Language Summary: Agreement between bioelectrical impedance analysis and dual-energy X-ray absorptiometry to estimate fat mass in adults with type 2 Diabetes Mellitus This study compares 2 methods for measuring body composition in patients with diabetes in Mexico. The first method is Bioelectrical Impedance Analysis (BIA), which is non-invasive, low-cost, and easy to use but may not be reliable in conditions that affect the body's hydration status, like diabetes. The second method is Dual-energy X-ray Absorptiometry (DXA), which is more accurate but less easily accessible. The study was a cross-sectional evaluation of 309 participants over 18 years with type 2 diabetes mellitus (T2DM) by HbA1C levels. The present study found BIA to be precise for body composition assessment but not accurate compared to DXA as the reference method. The study showed a trend of overestimating the diagnosis of obesity using BIA, especially in individuals with a higher fat mass index. This study found BIA is accurate at the group level but not at the individual level. The bias between the 2 methods showed a statistically significant overestimation of body fat by BIA. We provided a correction factor of 0.55 kg in men but not women. BIA is not ideal for diagnosing obesity but is reliable for tracking patient progress over time. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Chronic kidney disease acquired knowledge in a diabetic and hypertensive population using a translated and validated questionnaire.

Author

Maya-Quinta, Rogelio, Rodriguez-Gomez, Gloria P., Del Toro-Mijares, Raul, Henriquez-Santos, Fanny, and Martagon, Alexandro J.

Subjects
CHRONIC kidney failure, MEDICAL students, DISEASE risk factors, MEXICANS, CHRONIC diseases
Abstract

Chronic kidney disease (CKD) is the progressive and irreversible functional and/or structural impairment of the kidney; its main etiologies include hypertension and diabetes. Mexico has the second highest prevalence of CKD worldwide with a high economic burden affecting public and private health systems. Patients with higher knowledge about CKD increase their adherence to preventive treatment. In this study we aim to describe the knowledge of CKD in a sample of Mexican high-risk population, comparing it with general Mexican population, medical students and nephrologists. A cross-sectional, observational study was performed divided in two phases: translation and validation of the knowledge questionnaire to Spanish, and cross-sectional survey to evaluate the knowledge of CKD in patients with diagnosis of diabetes and/or hypertension. We interviewed medical students, general population, and nephrologists to attain validation of the questionnaire in Spanish. The questionnaire was answered by 1,061 participants within the high-risk population. The results of the questionnaire were: 22/24, 18/24, 13.8/24, and 13.4/24 in nephrologists, medical students, normal subjects, and high-risk population, respectively. The questions with least correct answers were related to kidney functions and CKD risk factors. To our knowledge this is the first time a questionnaire for CKD knowledge is applied in Mexican population. These findings suggest poor understanding of kidney functions, risk factors, and symptoms of CKD. It is important not only to provide medical treatment to chronic illness but also awareness of the consequences of not achieving goals of treatment. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Author

Vallejo-Vaz, Antonio J., Marco, Martina De, Stevens, Christophe A. T., Akram, Asif, Freiberger, Tomas, Hovingh, G. Kees, Kastelein, John J. P., Mata, Pedro, Raal, Frederick J., Santos, Raul D., Soran, Handrean, Watts, Gerald F., Abifadel, Marianne, Aguilar-Salinas, Carlos A., Al-Khnifsawi, Mutaz, Alkindi, Fahad A., Alnouri, Fahad, Alonso, Rodrigo, Al-Rasadi, Khalid, Al-Sarraf, Ahmad, Ashavaid, Tester F., Binder, Christoph J., Bogsrud, Martin P., Bourbon, Mafalda, Bruckert, Eric, Chlebus, Krzysztof, Corral, Pablo, Descamps, Olivier, Durst, Ronen, Ezhov, Marat, Fras, Zlatko, Genest, Jacques, Groselj, Urh, Harada-Shiba, Mariko, Kayikcioglu, Meral, Lalic, Katarina, Lam, Carolyn S. P., Latkovskis, Gustavs, Laufs, Ulrich, Liberopoulos, Evangelos, Lin, Jie, Maher, Vincent, Majano, Nelson, Marais, A. David, März, Winfried, Mirrakhimov, Erkin, Miserez, André R., Mitchenko, Olena, Nawawi, Hapizah M., Nordestgaard, B. rge G., Paragh, György, Petrulioniene, Zaneta, Pojskic, Belma, Postadzhiyan, Arman, Reda, Ashraf, Reiner, Željko, Sadoh, Wilson E., Sahebkar, Amirhossein, Shehab, Abdullah, Shek, Aleksander B., Stoll, Mario, Su, Ta-Chen, Subramaniam, Tavintharan, Susekov, Andrey V., Symeonides, Phivos, Tilney, Myra, Tomlinson, Brian, Truong, Thanh-Huong, Tselepis, Alexandros D., Tybjærg-Hansen, Anne, Vázquez-Cárdenas, Alejandra, Viigimaa, Margus, Vohnout, Branislav, Widén, Elisabeth, Yamashita, Shizuya, Banach, Maciej, Gaita, Dan, Jiang, Lixin, Nilsson, Lennart, Santos, Lourdes E., Schunkert, Heribert, Tokgözoğlu, Lale, Car, Josip, Catapano, Alberico L., Ray, Kausik K., Schreier, Laura, Pang, Jing, Dieplinger, Hans, Hanauer-Mader, Gabriele, Desutter, Johan, Langlois, Michel, Mertens, Ann, Rietzschel, Ernst, Wallemacq, Caroline, Isakovic, Dzenana, Dzankovic, Amra M., Obralija, Jasna, Pojskic, Lamija, Sisic, Ibrahim, Stimjanin, Ena, Torlak, Vildana A., Jannes, Cinthia E., Krieger, Jose E., Pereira, Alexandre C., Ruel, Isabelle, Asenjo, Sylvia, Cuevas, Ada, Pećin, Ivan, Miltiadous, George, Panayiotou, Andrie G., Vrablik, Michal, Benn, Marianne, Heinsar, Silver, Béliard, S., Gouni-Berthold, Ioanna, Hengstenberg, Wibke, Julius, Ulrich, Kassner, Ursula, Klose, Gerald, König, Christel, König, Wolfgang, Otte, Britta, Parhofer, Klaus, Schatz, Ulrike, Schmidt, Nina, Steinhagen-Thiessen, Elisabeth, Vogt, Anja, Antza, Christina, Athyros, Vasilios, Bilianou, Eleni, Boufidou, Amalia, Chrousos, George, Elisaf, Moses, Garoufi, Anastasia, Katsiki, Niki, Kolovou, Genovefa, Kotsis, Vasilios, Rallidis, Loukianos, Rizos, Christos, Skalidis, Emmanouel, Skoumas, Ioannis, Tziomalos, Kostantinos, Shawney, J. P. S., Abbaszadegan, Mohammad R., Aminzadeh, Majid, Hosseini, Sousan, Mobini, Moein, Vakili, Rahim, Zaeri, Hossein, Agar, Ruth, Boran, Gerard, Colwell, Nial, Crowley, Vivion, Durkin, Maeve, Griffin, Damian, Kelly, Michael, Rakovac-Tisdall, Ana, Bitzur, Rafael, Cohen, Hofit, Eliav, Osnat, Ellis, Avishay, Gavish, Dov, Harats, Dror, Henkin, Yaacov, Knobler, Hila, Leavit, Leah, Leitersdorf, Eran, Rubinstein, Ardon, Schurr, Daniel, Shpitzen, Shoshi, Szalat, Auryan, Arca, Marcello, Averna, Maurizio, Bertolini, Stefano, Calandra, Sebastiano, Tarugi, Patrizia, Erglis, Andrejs, Gilis, Dainus, Nesterovics, Georgijs, Saripo, Vita, Upena-Roze, Arta, Elbitar, Sandy, Jambart, S. lim, Khoury, Petra El, Gargalskaite, Urte, Kutkiene, Sandra, Al-Khateeb, Alyaa, An, Chua Y., Ismail, Zaliha, Kasim, Sazzli, Ibrahim, Khairul S., Radzi, Ahmad B. M., Kasim, Noor A., Nor, Noor S. M., Ramli, Anis S., Razak, Suraya A., Muid, Suhaila, Rosman, Azhari, Sanusi, Abd R., Razman, Aimi Z., Nazli, Sukma A., Kek, Teh L., Azzopardi, Conrad, Aguilar Salinas, Carlos A., Vázquez-Cárdenas, N. Alejandra, Galán, Gabriela, Magaña-Torres, M. T., Martagon, Alexandro, Mehta, Roopa, Wittekoek, M. E., Isara, Alphonsus R., Obaseki, Darlington E., Ohenhen, Oluwatoyin A., Holven, Kirsten B., Gruchała, Marcin, Baranowska, Marlena, Borowiec-Wolny, Justyna, Gilis-Malinowska, Natasza, Michalska-Grzonkowska, Aleksandra, Pajkowski, Marcin, Parczewska, Aleksandra, Romanowska-Kocejko, Marzena, Stróżyk, Aneta, Żarczyńska-Buchowiecka, Marta, Kleinschmidt, Mariola, Alves, Ana C., Medeiros, Ana M., Ershova, Alexandra, Korneva, Victoria, Kuznetsova, Tatiana, Malyshev, Pavel, Meshkov, Alexey, Rozhkova, Tatiana, Rajkovic, Natasa, Popovic, Ljiljana, Lukac, Sandra S., Stosic, Ljubica, Rasulic, Iva, Lalic, Nebojsa M., Chua, Terrance S. J., Ting, Sharon P. L., Raslova, Katarina, Battelino, Tadej, Cevc, Matija, Jug, Borut, Kovac, Jernej, Podkrajsek, Katarina T., Sustar, Ursa, Trontelj, Katja J., Marais, David, Isla, Leopoldo Perez de, Martin, François J., Charng, Ming-Ji, Chen, Pei-Lung, Kayikçioglu, Meral, Dell’oca, Nicolás, Fernández, Graciela, Ressia, Andrés, Reyes, Ximena, Zelarayan, Mario, Alieva, Rano B., Hoshimov, Shavkat U., Kurbanov, Ravshanbek D., Nizamov, Ulugbek I., Lima-Martínez, Marcos M., Nguyen, Mai-Ngoc Thi, Do, Doan-Loi, Kim, Ngoc-Thanh, le, Hong-An, le, Thanh-Tung, Centre of Excellence in Complex Disease Genetics, Elisabeth Ingrid Maria Widen / Principal Investigator, Institute for Molecular Medicine Finland, University of Helsinki, Genomic Discoveries and Clinical Translation, Kardiyoloji, Lee Kong Chian School of Medicine (LKCMedicine), Pfizer Incorporated, European Atherosclerosis Society, ACS - Atherosclerosis & ischemic syndromes, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, and Ege Üniversitesi

Subjects
International Cooperation, MÉTODOS EPIDEMIOLÓGICOS, 030204 cardiovascular system & hematology, Nationwide survey, Global Health, Health Services Accessibility, Doenças Cardio e Cérebro-vasculares, MOLECULAR-GENETICS, 0302 clinical medicine, Risk Factors, Prevalence, CARDIOVASCULAR RISK-FACTORS, 030212 general & internal medicine, Cooperative Behavior, DEFECTIVE APOLIPOPROTEIN B-100, GENERAL-POPULATION, education.field_of_study, medicine.diagnostic_test, Anticholesteremic Agents, Familial hypercholesterolaemia, FHSC, Primary dyslipidaemia, Biomarkers, Cholesterol, LDL, Genetic Predisposition to Disease, Health Care Surveys, Healthcare Disparities, Humans, Hyperlipoproteinemia Type II, Phenotype, Predictive Value of Tests, Treatment Outcome, Blood Component Removal, EAS Familial Hypercholesterolaemia Studies Collaboration, 3. Good health, PREVALENCE, Cholesterol, CORONARY-ARTERY-DISEASE, NATIONWIDE SURVEY, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Cardiovascular risk factors, Population, LDL-RECEPTOR, 1102 Cardiovascular Medicine And Haematology, LDL, 03 medical and health sciences, medicine, Medicine [Science], fhsc, familial hypercholesterolaemia, primary dyslipidaemia, education, Genetic testing, Government, Public health, EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC) Investigators, SAFEHEART REGISTRY, 1103 Clinical Sciences, Cardiovascular System & Hematology, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Cardiovascular System & Cardiology, Business, FOLLOW-UP
Abstract

PubMed: 30270054, 2-s2.0-85053666909, Background and aims: Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries. Methods: Lead Investigators from countries formally involved in the EAS FHSC by mid-May 2018 were invited to provide a brief report on FH status in their countries, including available information, programmes, initiatives, and management. Results: 63 countries provided reports. Data on FH prevalence are lacking in most countries. Where available, data tend to align with recent estimates, suggesting a higher frequency than that traditionally considered. Low rates of FH detection are reported across all regions. National registries and education programmes to improve FH awareness/knowledge are a recognised priority, but funding is often lacking. In most countries, diagnosis primarily relies on the Dutch Lipid Clinics Network criteria. Although available in many countries, genetic testing is not widely implemented (frequent cost issues). There are only a few national official government programmes for FH. Under-treatment is an issue. FH therapy is not universally reimbursed. PCSK9-inhibitors are available in ?2/3 countries. Lipoprotein-apheresis is offered in ?60% countries, although access is limited. Conclusions: FH is a recognised public health concern. Management varies widely across countries, with overall suboptimal identification and under-treatment. Efforts and initiatives to improve FH knowledge and management are underway, including development of national registries, but support, particularly from health authorities, and better funding are greatly needed. © 2018 Elsevier B.V., Universidade de São Paulo, USP European Atherosclerosis Society, EAS Amgen Merck Sharp and Dohme, MSD, The ELSA Study suggests heterozygous FH (HeFH) may affect 1:263 Brazilians (?766,000 individuals). Currently, the only active genetic cascade screening program in Brazil is Hipercol Brasil in Sao Paulo (genetic testing for adults with low-density lipoprotein cholesterol (LDL-C) ?230?mg/dL, to maximise cost-effectiveness), with 1719 heterozygotes, 25 homozygotes, 13 compound-heterozygotes and one double-heterozygote identified by March 2018. To date, 4340 individuals from 440 families were screened. Genetic testing is funded by a government tax reduction programme (PROADI-SUS), and cascade screening by partnering between Samaritano Hospital and Heart Institute (InCor) University of Sao Paulo. Most FH patients are under non-specialist care and currently under-treated., Prevalence is unknown but assumed at 1:250. There is no state programme and few patients were diagnosed before the Latvian FH Registry was established in 2015. To date, the Registry has identified 181 cases (2.3% of 7876 estimated HeFH cases; no HoFH). Cascade screening is performed in first-degree relatives of index cases with probable/definite FH. Genetic testing is not reimbursed but has been funded by research grants for a few patients/relatives. About 5% of patients had LDL-C at target before inclusion in the Registry [ 61 ]. Statins are reimbursed 50% in primary prevention; statins and ezetimibe, 75–100% in secondary prevention; PCSK9i are available, but not reimbursed., Estimated prevalence is 1:250 (based on a meta-analysis of 6 observational studies) or 136,300 adults (only 2% diagnosed) [ 69 , 70 ]. Based on LIPIDOGRAM studies (2004–2015, ?50,000 participants), prevalence might be?1:200 [ 71 , 72 ]. Five HoFH cases are described [ 73 , 74 ]. Patients with DLCN ?3 are referred for genetic testing, funded by the National Health Program. The National Centre for FH at University Clinical Hospital, Medical University of Gdansk, was established in 2017, financed by the Ministry of Health. From August 2017, 345 patients underwent genetic testing (153 positive, including 46 relatives; 1 HoFH). Since 1999, 1884 patients (562 families) have undergone genetic testing and cascade diagnosis (data from the National Polish FH Registry, Medical University of Gdansk, established in 2000). PCSK9i are not reimbursed (under discussion with the Ministry of Health)., The EAS FHSC project has received support from a Pfizer Independent Grant for Learning & Change 2014 (No: 16157823 ) and from investigator-initiated unrestricted research grants to the European Atherosclerosis Society from Amgen , MSD , and Sanofi-Aventis .

Published
2018

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