ABSTRACT
Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-"B" & "O", blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetic's patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.
Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos "B" e "O", sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.
Subject(s)
Humans , Rh-Hr Blood-Group System , Diabetes Mellitus/epidemiology , Pakistan/epidemiology , ABO Blood-Group System , CitiesABSTRACT
A conformidade entre as fontes de dados sobre diabetes mellitus (DM) e hipertensão arterial (HA) é fundamental para medidas de vigilância. Neste aspecto, pretende Avaliar se há uniformidade entre os dados de prevalência de DM e HA no Estado de Goiás a partir de duas diferentes fontes de acesso a esses dados. Casuística e métodos: Comparação entre os dados do Levantamento de Hipertensão e Diabetes do estado de Goiás 2021 (LHD) e do banco de dados da Estratégia e-SUS Atenção Básica (e-SUS AB) com relação ao número de indivíduos cadastrados na rede de atenção primária à saúde com os diagnósticos de DM e HA. Resultados: Em Goiás, a diferença entre o número absoluto de indivíduos com diagnóstico de DM e HA pelo LHD e pelo e-SUS AB foi de 46,56% e de 27%, respectivamente (p <0,001). A diferença entre os dados foi maior que 50% para o diagnóstico de DM em 104 municípios e para HA em 94 municípios. Discussão: As divergências encontradas podem estar relacionadas a fatores como a qualidade dos dados fornecidos pela população, duplicidade de registros, problemas técnicos relacionados à internet e ao software e dificuldades na integração entre os sistemas de informação. Demonstra-se a necessidade de padronização de registros e uniformização dos dados para o fortalecimento de ações de vigilância. Concluiu que há inconsistências entre os dados sobre o número de indivíduos cadastrados com os diagnósticos de DM e HA a partir do LHD e e-SUS AB em grande parte dos municípios do Estado de Goiás
Introduction: Conformity between data sources on diabetes mellitus (DM) and hypertension (H) is critical for surveillance measures. Objective: To assess whether there is uniformity between data on the prevalence of DM and H in the State of Goiás, based on two different sources of access to these data. Material and methods: A comparison was made between the data from the 2021 Hypertension and Diabetes Survey of the State of Goiás (LHD) and the data from the e-SUS Primary Care Strategy (e-SUS AB) database about the number of people who had hypertension or diabetes. RESULTS: In Goiás, the difference between the absolute number of individuals diagnosed with DM and H according to data from the LHD and e-SUS AB was 46.56% and 27%, respectively (p <0.001). The difference between the data was greater than 50% for the diagnosis of DM in 104 municipalities and for H in 94 municipalities. Discussion: The differences found may be related to the quality of personal data provided by the population, duplicate records, obstacles in using the software or the internet, difficulties in integrating information systems. The findings demonstrate the necessity of establishing standardized records for data related to these diseases in order to strengthen surveillance actions. Conclusion: There are inconsistencies between the data on the number of individuals registered as having DM and H from the LHD and e-SUS AB in most municipalities in the State of Goiás
Subject(s)
Humans , Male , Female , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Diseases Registries/statistics & numerical data , Health Information Systems/statistics & numerical dataABSTRACT
Abstract Background: Public programs that provide access to essential medications have played an important role in the care of hypertensive and diabetic patients. However, access in small municipalities has been poorly studied. Objectives: To describe the sociodemographic profile and the medication and health service usage of patients with systemic arterial hypertension and/or diabetes mellitus in a small municipality who use the public medication access programs Health has no Price (Saúde Não Tem Preço - SNTP) and the Minas Pharmacy Network. Methods: This cross-sectional study with 341 participants was conducted in 2019. Home interviews were conducted using a standardized, semi-structured questionnaire. The data are expressed as absolute and relative frequencies, and Pearson's chi-square test was used for comparisons between proportions (α = 5%). Results: Most of the participants (70.68%) had hypertension only, 11.14% had diabetes only, and 18.18% had both. Regarding the origin of the hypertension medications, 82.67% were provided by the Minas Pharmacy Network and/or SNTP programs. Regarding oral hypoglycemic agents and insulins, 88.61% were provided by the Minas Pharmacy Network and/or SNTP. Most participants were female (63.1%), at least 65 years of age (50.30%), non-White (66.96%), resided in an urban area (67.16%), were illiterate or had a low education level (89.94%), and had a maximum income ≤ 2 times the federal minimum salary (89.19%). Overall user perception was significantly better for SNTP (p=0.010). Conclusion: The results of this study indicate that programs which provide access to essential medications are important sources of hypertension and diabetes medications in the study area, especially for people with low incomes.
Subject(s)
Diabetes Mellitus/epidemiology , National Drug Policy , Access to Essential Medicines and Health Technologies , Hypertension/epidemiology , Pharmaceutical Services/supply & distribution , Cross-Sectional Studies , Diabetes Mellitus/drug therapy , Hypertension/drug therapyABSTRACT
INTRODUCCIÓN: Se ha postulado la relación entre la presencia de enfermedades cardiometabólicas con problemas de salud mental, en particular la depresión. OBJETIVOS: Determinar la asociación entre la presencia de enfermedades cardiometabólicas y la presencia de sintomatología depresiva evaluada mediante el cuestionario PHQ-9 en pacientes atendidos en consultorios externos de medicina interna del Hospital Nacional Hipólito Unanue. METODOLOGÍA: Estudio observacional, analítico, transversal. Se definió enfermedad cardiometabólica como la presencia de diabetes mellitus, hipertensión arterial, dislipidemia, y/u obesidad. Se utilizó el cuestionario PHQ-9 para evaluar la presencia de síntomas sugerentes de depresión. Se evaluó la asociación cruda y ajustada a posibles confusores. Para el análisis multivariado se utilizó un modelo de regresión de Poisson para hallar razones de prevalencia con sus respectivos intervalos de confianza al 95%. Se consideró un p<0,05 como estadísticamente significativo. Resultados: Se incluyeron 252 pacientes, de los que 205 (81,4%) presentaron enfermedades cardiometabólicas y 181 (71,9%) presentaron síntomas consistentes con algún grado de depresión. La presencia de enfermedades cardiometabólicas se asoció a síntomas depresivos tanto en el análisis crudo (RPc 1,43; IC 95% 1,08-1,89; p=0,012) como en el ajustado (RPa 1,31; IC 95% 1,00-1,71; p=0,048). Adicionalmente se encontró asociación entre el sexo femenino y sintomatología depresiva (RPa 1,35; IC 95% 1,11-1,63; p=0,002). CONCLUSIONES: La presencia de enfermedades cardiometabólicas se asoció con la presencia de síntomas depresivos en pacientes atendidos en la consulta externa de medicina interna. El abordaje de la salud mental debe ser parte integral del manejo multidisciplinario del paciente con enfermedad cardiometabólica.
INTRODUCTION: It has been postulated the relationship between presence of cardiometabolic diseases with mental health problems, particularly depression. Objectives: To determine the association between cardiometabolic diseases and presence of depressive symptoms, evaluated by PHQ-9 questionnaire, in patients attended at the outpatient clinic of internal medicine service at Hospital Nacional Hipolito Unanue. METHODS: Observational analytical cross-sectional study. Cardiometabolic disease was defined as the presence of diabetes mellitus, high blood pressure, dyslipidemia, and/or obesity. The PHQ-9 questionnaire was used to evaluate the presence of symptoms suggestive of depression. The association was evaluated crude and adjusted for possible confounders. For the multivariate analysis, a Poisson regression model was used to find prevalence ratios with their respective 95% confidence intervals. A p<0.05 was considered statistically significant. RESULTS: 252 patients were included, of which 205 (81,4%) presented cardiometabolic diseases and 181 (71,9%) presented symptoms consistent with some grade of depression. The presence of cardiometabolic diseases was associated with depressive symptoms both in the crude analysis (PRc 1.43; CI 95% 1.08-1.89; p=0.012) and in the adjusted one (PRa 1.31; CI 95% 1.00-1.71; p=0.048). Additionally, an association was found between female sex and depressive symptoms (PRa 1,35; CI 95% 1,11-1,63; p=0,002). CONCLUSIONS: The presence of cardiometabolic diseases was associated with the presence of depressive symptoms in patients seen at the outpatient clinic of internal medicine. The mental health approach should be an integral part of the multidisciplinary management for the patient with cardiometabolic disease.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiovascular Diseases/psychology , Cardiovascular Diseases/epidemiology , Metabolic Syndrome/psychology , Metabolic Syndrome/epidemiology , Depression/epidemiology , Peru , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Diabetes Mellitus/psychology , Diabetes Mellitus/epidemiology , Dyslipidemias/psychology , Dyslipidemias/epidemiology , Hospitals , Hypertension/psychology , Hypertension/epidemiology , Obesity/psychology , Obesity/epidemiologyABSTRACT
Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Cardiovascular Diseases/epidemiology , Cardiometabolic Risk Factors , Brazil , Logistic Models , Odds Ratio , Prevalence , Cross-Sectional Studies , Health Surveys , Morbidity , Age Factors , Diabetes Mellitus/epidemiology , Age and Sex Distribution , Dyslipidemias/epidemiology , Waist-Height Ratio , Hypertension/epidemiology , Obesity/epidemiologyABSTRACT
Introdução: As doenças crônicas não transmissíveis (DCNT) incluindo diabetes (DM) e hipertensão arterial sistêmica (HAS) são responsáveis por grande parte das mortes mundiais atualmente, sendo a identificação de fatores associados uma ferramenta fundamental para sua prevenção e estratégias de promoção da saúde. Objetivo: Determinar a prevalência de HAS e DM na população adulta atendida pelo Projeto Vozes das Ruas (PVR) em Jundiaí (SP) e fatores associados. Métodos: Os participantes do estudo transversal, conduzido de março a novembro de 2019, foram adultos acima de 18 anos, voluntários das ações de promoção de saúde do PVR em 2019, que consistiram na aplicação de um questionário sociodemográfico e de comportamentos em saúde; na avaliação de glicemia capilar, pressão arterial, peso, altura e circunferência abdominal; e posterior aconselhamento em saúde. Realizou-se análise descritiva dos dados para verificar a associação dos desfechos DM e HAS com variáveis independentes. Utilizaram-se teste χ2 e regressão logística multivariada para variáveis com p<0,20, adotando-se a significância de 5%. Resultados: A amostra foi composta de 580 participantes, 50% do sexo feminino e com idade média de 48,56 anos. A prevalência autodeclarada de DM foi 16,2% e de HAS, 30,2%. Os fatores associados em comum foram: faixa etária acima de 39 anos e uso de medicação contínua. Associados à DM foram: antecedente familiar de DM, uso de unidade básica de saúde, histórico de tabagismo. Em relação à HAS as associações foram: menos de oito anos de estudo, sobrepeso e obesidade. Conclusões: Na população estudada houve elevada prevalência de duas das principais DCNT HAS e DM que apresentaram fatores associados de extrema relevância para o planejamento de estratégias de promoção da saúde e prevenção de doenças.
Introduction: Chronic noncommunicable diseases (NCDs) including diabetes mellitus (DM) and systemic arterial hypertension (SAH) are responsible for most of the worldwide deaths today, and the identification of associated factors is an essential tool for their prevention and health promotion strategies. Objective: To determine the prevalence of SAH and DM in the adult population served by Projeto Vozes das Ruas (PVR) in Jundiaí, SP, Brazil and associated factors. Methods: A cross-sectional study was carried out from March to November 2019, with a sample of adults over 18 years of age, participating in PVR's health promotion actions in 2019, which consisted in the application of a sociodemographic and health behavior questionnaire, evaluation of capillary glucose, blood pressure, weight, height and waist circumference and subsequent health counseling. Descriptive analysis of the data was performed to determine the association of the outcomes DM and SAH with independent variables. A chi-square test was carried out and variables with p<0.20 were included in multivariate logistic regression (p<0.05). Results: The sample consisted of 50% females with an average age of 48.56 years. The self-reported prevalence of DM was 16.2% and SAH 30.2%, with a relationship between them. The common associated factors were: age group over 39 years and continuous-use medications. Associated with DM were family history of DM, use of basic health unit and smoking history. In relation to SAH the associations were less than eight years of schooling, overweight and obesity and smoking. Conclusions: In the population studied, there was a high prevalence of two of the main NCDs, SAH and DM, which presented risk factors of extreme relevance for the planning of health promotion and disease prevention strategies
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Noncommunicable Diseases/epidemiologyABSTRACT
RESUMO Objetivo: estimar a prevalência de dislipidemias e os fatores associados em adultos de Rio Branco, Acre. Métodos: estudo de delineamento seccional, populacional, que avaliou adultos (18 a 59 anos) residentes nas zonas urbana e rural de Rio Branco em 2014. As dislipidemias foram definidas conforme os critérios da Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Ateroscle rose. Empregou-se regressão logística para estimar as odds ratio (OR) e intervalos de confiança de 95% (IC95%). Resultados: a prevalência de dislipidemia, HDL-c baixo, hipertrigliceridemia isolada, hipercolesterolemia isolada e hiperlipidemia mista foi de 56,1%, 37,4%, 23,6%, 9,8% e 3,5%, respectivamente. No modelo final multivariado, apenas a obesidade (OR = 1,86; IC95%: 1,12;3,10) manteve associação estatisticamente significativa com a dislipidemia. Entre os subtipos de dislipidemias, associaram-se à hipertrigliceridemia isolada as variáveis: faixa etária de 40 a 49 anos (OR = 2,17; IC95%: 1,53;4,80); hipercolesterolemia isolada (OR = 2,52; IC95%: 1,23;5,15); HDL-c baixo (OR = 2,53; IC95%: 1,65;3,86); obesidade (OR = 2,10; IC95%: 1,25;3,53); e diabetes mellitus (OR = 5,41; IC95%: 1,46;20,4). Conclusão: a prevalência de alterações lipídicas foi elevada entre adultos. Estratégias de intervenções para diagnóstico, tratamento e intensificação de medidas preventivas e orientações de estilo de vida saudáveis são importantes nessa população.
RESUMEN Objetivo: estimar la prevalencia de dislipidemias y los factores asociados en adultos de Rio Branco, Acre-Brasil. Métodos: estudio de investigación seccional, poblacional, que evaluó adultos (18 a 59 años) residentes en las zonas urbana y rural de Rio Branco en 2014. Las dislipidemias fueron definidas conforme a los criterios de la Actualización de la Directriz Brasileña de Dislipidemias y Prevención de la Aterosclerosis. Se empleó regresión logística para estimar las odds ratio (OR) e intervalos de confianza del 95% (IC95%). Resultados: la prevalencia de dislipidemia, HDL-c bajo, hipertrigliceridemia aislada, hipercolesterolemia aislada e hiperlipidemia mixta fue de 56,1%, 37,4%, 23,6%, 9,8% y 3,5%, respectivamente. En el modelo final multivariado, solo la obesidad (OR = 1,86; IC95%: 1,12;3,10) mantuvo una asociación estadísticamente significativa con la dislipidemia. Entre los subtipos de dislipidemias, se asociaron a la hipertrigliceridemia aislada las variables: franja etaria de 40 a 49 años (OR = 2,17; IC95%: 1,53;4,80); hipercolesterolemia aislada (OR = 2,52; IC95%: 1,23;5,15); HDL-c bajo (OR = 2,53; IC95%: 1,65;3,86); obesidad (OR = 2,10; IC95%: 1,25;3,53); y diabetes mellitus (OR = 5,41; IC95%: 1,46;20,4). Conclusión: la prevalencia de cambios lipídicos fue elevada entre adultos. Estrategias de intervenciones para el diagnóstico, tratamiento e intensificación de medidas preventivas y orientaciones de estilo de vida saludables son importantes en esa población.
ABSTRACT Objective: to estimate the prevalence of dyslipidemia and associated factors in adults in Rio Branco, Acre. Methods: a cross-sectional, population-based study that assessed adults (age 18 to 59 years) living in urban and rural areas of Rio Branco in 2014. Dyslipidemias were defined according to the criteria of the Brazilian Guidelines Update on Dyslipidemias and Prevention of Atherosclerosis. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI95%). Results: the prevalence of dyslipidemia, low HDL-c, isolated hypertriglyceridemia, isolated hypercholesterolemia and mixed hyperlipidemia was 56.1%, 37.4%, 23.6%, 9.8% and 3.5%, respectively. In the final multivariate model, only obesity (OR = 1.86; CI95%: 1.12; 3.10) maintained a statistically significant association with dyslipidemia. Among the dyslipidemia subtypes, the following variables were associated with isolated hypertriglyceridemia: age group 40 to 49 years (OR = 2.17; CI95%: 1.53; 4.80); isolated hypercholesterolemia (OR = 2.52; CI95%: 1.23; 5.15); low HDL-c (OR = 2.53; CI95%: 1.65; 3.86); obesity (OR = 2.10; CI95%: 1.25;3.53); and diabetes mellitus (OR = 5.41; CI95%: 1.46; 20.4). Conclusion: the prevalence of lipid alterations was high among adults. Intervention strategies for diagnosis, treatment and intensification of preventive measures and healthy lifestyle guidelines are important in this population.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Prevalence , Adult , Dyslipidemias/epidemiology , Hypertriglyceridemia/epidemiology , Epidemiology , Cross-Sectional Studies/methods , Diabetes Mellitus/epidemiology , Hypercholesterolemia/epidemiology , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Obesity/epidemiologyABSTRACT
Objetivo: Comparar indicadores de cuidado assistencial em adultos com diagnóstico médico de diabetes mellitus (DM) no Brasil em 2013 e 2019, e analisar esses indicadores, em 2019, segundo características sociodemográficas. Métodos: Estudo transversal com dados da Pesquisa Nacional de Saúde de 2013 e 2019. Foram avaliados os indicadores de cuidado em pessoas com diagnóstico médico de DM. Resultados: A prevalência de DM aumentou de 6,2% (2013) para 7,7% (2019). Entre 2013 e 2019, ocorreu aumento no uso de medicamentos (de 80,2% para 88,8%) e de assistência médica (de 73,2% para 79,1%), houve redução no uso de medicamentos da Farmácia Popular (de 57,4% para 51,5%) e no acompanhamento com mesmo médico (de 65,2% para 59,4%). Em 2019, pessoas do sexo masculino, mais jovens, de raça/cor da pele preta e parda, menores escolaridade e renda apresentaram pior desempenho nos indicadores. Conclusão: A maioria dos indicadores permaneceu semelhante durante os últimos cinco anos, com diferenças segundo características sociodemográficas em 2019.
Objetivo: Comparar indicadores de atención de salud para adultos con diagnóstico médico de diabetes mellitus (DM) en Brasil, en 2013 y 2019, y analizar estos indicadores, en 2019, según características sociodemográficas. Métodos: Estudio transversal con datos de la Encuesta Nacional de Salud de 2013 y 2019. Se evaluaron indicadores de atención en personas con diagnóstico médico de DM. Resultados: La prevalencia de DM aumentó del 6,2% (2013) al 7,7% (2019). Entre 2013 y 2019 hubo aumento en uso de medicamentos (80,2% a 88,8%) y de atención médica (73,2% a 79,1%), reducción en uso de medicamentos de Farmacia Popular (57, 4% a 51,5%) y seguimiento con mismo médico (65,2% a 59,4%). En 2019, personas de sexo masculino, más jóvenes, de la raza/color de piel negra y mestiza, menor nivel educativo e ingresos mostraron un peor desempeño en los indicadores. Conclusión: La mayoría de los indicadores se mantuvieron similares durante los últimos cinco años, con diferencias según las características sociodemográficas en 2019.
Objective: To compare health care indicators for adults with medical diagnosis of diabetes mellitus (DM) in Brazil, in 2013 and 2019, and analyze the indicators for 2019 according to sociodemographic characteristics. Methods: Cross-sectional study using data from the 2013 and 2019 National Health Survey. Care indicators were evaluated in people with medical diagnosis of DM. Results: DM prevalence increased from 6.2% (2013) to 7.7% (2019). Between 2013 and 2019, there was an increase in the use of medications (from 80.2% to 88.8%) and of medical care (from 73.2% to 79.1%), a reduction in the use of Popular Pharmacy Program medications (from 57.4% to 51.5%) and in follow-up with the same physician (from 65.2% to 59.4%). In 2019, poorer indicators were observed for individuals who were male, younger, Black and Brown, and with lower education and income. Conclusion: Most indicators remained similar in the last five years, with differences according to sociodemographic characteristics in 2019.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Quality Indicators, Health Care , Diabetes Mellitus/therapy , Diabetes Mellitus/epidemiology , Brazil/epidemiology , Chronic Disease/epidemiology , Cross-Sectional Studies , Health Surveys , Health Services AccessibilityABSTRACT
The prevalence of diabetes has been growing worldwide. This study aimed to estimate the prevalence of self-reported diabetes in Brazil in 2019, to describe its evolution from 2013, and to evaluate the role of population growth, aging, and other factors in the changes found. The 2019 Brazilian National Health Survey, a nationally representative cross-sectional survey, queried a physician diagnosis of diabetes in a probabilistic multistage cluster sample. The crude prevalence of known diabetes in 2019 was 7.7% (7.4%-8.0%), a 24% relative increase to the prevalence of 2013. Though this increase was greater in men (30%) than women (20%), 2019 prevalence remained higher in women (8.4%) than in men (6.9%). Age-adjusted prevalence was uniformly lower in the North region, and uniformly higher in the Southeast and Central-West regions. In 2019, 12.3 million cases of diabetes were found, a 36.4% increase from the 9.0 million in 2013. Drivers of this rise include increase in size (9.9%) and aging (1.8%) of the Brazilian population, and to all other factors, including increased case-detection and incidence, as well as decreased diabetes mortality (24.7%). Main correlates of greater prevalence - adjusted by the Poisson regression with robust variance - were older age (PR = 27.2, 95%CI: 1.2-42.9 for ≥ 65 years vs. 18-24 years), hypertension (PR = 2.6, 95%CI: 2.4-2.8 vs. normotension), and obesity (PR = 2.3, 95%CI: 2.1-2.5 vs. BMI < 25kg/m2). Those with a complete higher education had a 40% lower prevalence (PR = 0.6; 95%CI: 0.54-0.70 vs. incomplete elementary education). In conclusion, accompanying a worldwide trend, Brazil presents an increasing prevalence of diabetes throughout its regions, posing a huge burden to its population and health systems.
A prevalência do diabetes mellitus tem crescido em nível global. O estudo buscou estimar a prevalência de autorrelato de diabetes no Brasil em 2019, descrever a evolução a partir de 2013 e avaliar o papel do crescimento demográfico, envelhecimento e outros fatores observados. A Pesquisa Nacional de Saúde de 2019, um inquérito transversal com representatividade nacional, perguntou sobre diagnóstico médico de diabetes em uma amostra probabilística por conglomerados com múltiplos estágios. A prevalência bruta de diabetes conhecido em 2019 foi de 7,7% (7,4%-8,0%), um aumento de 24% em relação à prevalência em 2013. Embora o aumento relativo tenha sido maior em homens (30%) que em mulheres (20%), a prevalência em 2019 permaneceu mais elevada em mulheres (8,4%) que em homens (6,9%). A prevalência ajustada por idade foi consistentemente mais baixa na Região Norte, e consistentemente mais alta nas regiões Sudeste e Centro-oeste. Em 2019, foram diagnosticados 12,3 milhões de casos de diabetes, um aumento de 36,4% em relação aos 9,0 milhões de casos em 2013. Fatores que explicam esse crescimento incluem aumento do tamanho (9,9%) e do envelhecimento (1,8%) da população brasileira, e outros fatores como o aumento na detecção de casos e na incidência, além de uma queda na mortalidade por diabetes (24,7%). As principais associações para uma maior prevalência - ajustada por regressão de Poisson com variância robusta - foram idade mais velha (RP = 27,2; IC95%: 1,2-42,9 para ≥ 65 anos vs. 18-24 anos), hipertensão (RP = 2,6; IC95%: 2,4-2,8 vs. normotensão) e obesidade (RP = 2,3; IC95%: 2,1-2,5 vs. IMC < 25kg/m2). Indivíduos com Nível Universitário completo tiveram uma prevalência 40% mais baixa (RP = 0,6; IC95%: 0,54-0,70 vs. Fundamental incompleto). Como conclusão, refletindo uma tendência mundial, o Brasil apresenta prevalência crescente de diabetes em todas as macrorregiões, o que cria uma enorme carga para a população e os sistemas de saúde.
La prevalencia de la diabetes ha estado creciendo alrededor de todo el mundo. El objetivo de este estudio fue estimar la prevalencia de la diabetes autoinformada en Brasil en 2019, para describir su evolución desde 2013, así como para evaluar el papel del crecimiento de la población, envejecimiento, y otros factores en los cambios encontrados. Se utilizó la Encuesta Nacional de Salud brasileña de 2019, una encuesta transversal representativa nacionalmente, donde se consultó el diagnóstico médico de diabetes en una muestra probabilística por conglomerados multietapa. La prevalencia cruda de la diabetes conocida en 2019 fue 7,7% (7,4%-8,0%), con un 24% de incremento relativo respecto a la prevalencia de 2013. Sin embargo, este aumento fue mayor en hombres (30%) que en mujeres (20%). La prevalencia de 2019 permaneció más alta en mujeres (8,4%) que en hombres (6,9%). La prevalencia ajustada a la edad fue uniformemente más baja en la Región Norte, y uniformemente más alta en las regiones del Sudeste y Centro-oeste. En 2019, hubo 12,3 millones de casos de diabetes, lo que supuso un incremento de 36.4% desde los 9,0 millones en 2013. Las causas incluyen el aumento de peso (9,9%) y el envejecimiento (1,8%) de la población brasileña, así como para el resto de todos los factores, incluyendo el incremento de la detección de casos e incidencia, al igual que el decremento en la mortalidad por diabetes (24,7%). Los principales factores de correlación para una mayor prevalencia -ajustados por regresión de Poisson con variancia robusta- fueron una edad más avanzada (PR = 27,2; IC95%: 1,2-42,9 para ≥ 65 años vs. 18-24 años), hipertensión (PR = 2,6; IC95%: 2,4-2,8 vs. normotensión), y obesidad (PR = 2,3; IC95%: 2,1-2,5 vs. BMI < 25kg/m2). Quienes contaban con una educación superior completa tenían una prevalencia un 40% más baja (PR = 0,6; IC95%: 0,54-0,70 vs. quienes tenían la educación básica incompleta). En conclusión, acompañando una tendencia global, Brasil presenta un incremento de prevalencia de la diabetes a través de sus regiones, planteando una carga inmensa para su población y sistemas de salud.
Subject(s)
Diabetes Mellitus/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Health SurveysABSTRACT
This study assesses changes in the prevalence and distribution of noncommunicable diseases (NCDs) and related risk factors among Brazilian adults from the 2013 and 2019 Brazilian National Health Surveys (PNS). It is based on the hypothesis that deteriorating socioeconomic conditions over this period would lead to increased NCDs among the least advantaged populations. We estimated adjusted prevalence ratios by education category and three inequality measures - the slope index of inequality (SII), the relative index of inequality (RII), and population attributable fraction (PAF) - for obesity, hypertension, arthritis, asthma, cancer, depression, diabetes, heart disease, having any chronic condition, and multimorbidity by survey year. We also estimated the 27 Brazilian Federative Units RII and prevalence rates for diabetes and multimorbidity per year and plotted the RII against prevalence by year. Results showed that all NCDs increased over the period observed, ranging from an 8% increase in the adjusted prevalence of arthritis to a 24% increase in the adjusted prevalence of obesity. Measures of inequality showed that most conditions exhibited significant educational inequities in both 2013 and 2019. However, on average, education-based inequities did not significantly change between the two periods. Considering the deterioration of the socioeconomic conditions of most Brazilians, the erosion of social protections, and the continuing economic, political, and health crises occurring in the nation, we observed an urgent need for discussion about the best way to adopt equity-promoting health policies and programs and action to reduce socioeconomic and geographic inequalities in NCDs throughout the country.
O artigo avalia mudanças na prevalência e distribuição de doenças crônicas não transmissíveis (DCNTs) e fatores de risco associados entre adultos brasileiros nas edições de 2013 e 2019 da Pesquisa Nacional de Saúde (PNS), com base na hipótese de que a piora das condições socioeconômicas durante o período tenha levado a um aumento das DCNTs entre as populações mais vulneráveis. Estimamos razões de prevalência ajustadas por categoria de escolaridade e três medidas de desigualdade - índice de desigualdade absoluta (SII), índice relativo de desigualdade (RII) e fração atribuível à população (PAF) - para obesidade, hipertensão, artrite, asma, câncer, depressão, diabetes, doenças cardíacas, qualquer condição crônica e multimorbidade, por ano da pesquisa. Para as 27 Unidades da Federação, estimamos também as taxas de prevalência de diabetes e de multimorbidade por ano e cotejamos os RII com as taxas de prevalência por ano. Os resultados mostram que todas as DCNTs aumentaram ao longo do período de observação, desde um aumento de 8% na prevalência ajustada de artrite a um aumento de 24% na prevalência ajustada de obesidade. As medidas de desigualdade revelam que a maioria das DCNTs mostrou inequidades significativas em relação à escolaridade, tanto em 2013 quanto em 2019. Entretanto, em média, as inequidades com base na escolaridade não mudaram entre os dois períodos. Devido à deterioração das condições socioeconômicas para a maioria dos brasileiros, à erosão das proteções sociais e à continuação das crises econômica, política e sanitária enfrentadas pela nação, há necessidade urgente de um debate sobre as melhores políticas e programas de saúde para promover a equidade e reduzir desigualdades socieconômicas e geográficas das DCNTs em todo o país
Este trabajo evalúa los cambios en la prevalencia y distribución de las enfermedades no transmisibles (ENT) y factores de riesgo relacionados entre adultos brasileños en las Encuestas Nacionales de Salud (PNS) de 2013 y 2019 , basadas en la hipótesis de que las condiciones económicas en deterioro durante este período conducirían a ENTs entre los grupos de población menos favorecidos. Estimamos las ratios de prevalencia ajustados por categoría de educación y tres medidas de desigualdad -la curva del índice de desigualdad (SII), el índice relativo de desigualdad (RII), y la fracción atribuible de población (PAF)- para obesidad, hipertensión, artritis, asma, cáncer, depresión, diabetes, enfermedad cardiovascular, padeciendo alguna condición crónica, y multimorbilidad por año de encuesta. También estimamos 27 estados de RII y tasas de prevalencia para la diabetes y multimorbilidad por año, y se plantearon los RII frente a la prevalencia por año. Los resultados muestran que todas las ENTs se incrementaron durante el período observado, yendo desde un 8% de incremento en la prevalencia ajustada por artritis hasta un 24% de incremento en la prevalencia ajustada por obesidad. Las medidas de desigualdad muestran que la mayoría de las condiciones expuestas presentan inequidades educacionales significativas, tanto en 2013, como en 2019. No obstante, como promedio, las inequidades relacionadas con la educación no cambiaban significativamente durante los dos períodos. Debido al deterioro de las condiciones socioeconómicas de la mayoría de los brasileños, la erosión de la protección social, y las continuas crisis económicas, políticas, y de salud, que enfrenta la nación, existe una urgente necesidad de debatir sobre el mejor camino para adoptar medidas que promuevan la equidad en las políticas de salud y sus programas, así como acciones para conseguir reducciones en las desigualdades socioeconómicas y geográficas en las ENTs en todo el país.
Subject(s)
Humans , Adult , Arthritis/epidemiology , Diabetes Mellitus/epidemiology , Noncommunicable Diseases/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Prevalence , Health Surveys , Educational Status , Health Status Disparities , Health Inequities , Obesity/epidemiologyABSTRACT
Objetivo: Analisar a associação entre diabetes mellitus e óbito hospitalar por COVID-19 no Brasil, de fevereiro a agosto de 2020. Métodos: Estudo transversal, sobre casos notificados como síndrome gripal no Sistema de Informação de Vigilância da Gripe, positivos para COVID-19 e hospitalizados. A magnitude da associação do diabetes com o óbito foi estimada por regressão de Poisson com variância robusta. Resultados: Foram analisados dados de 397.600 casos hospitalizados, dos quais 32,0% (n = 127.231) evoluíram a óbito. A prevalência de óbito entre pessoas com diabetes foi de 40,8% (RP = 1,41; IC95% 1,39;1,42). Após ajustes por variáveis sociodemográficas e comorbidades, observou-se que o óbito foi 1,15 vez mais frequente entre aqueles com diabetes (IC95% 1,14;1,16). Conclusão: 3 a cada 20 óbitos por COVID-19 ocorreram em indivíduos com diabetes mellitus, destacando-se a suscetibilidade dessa população e a necessidade de controle dessa doença crônica.
Objetivo: Analizar la asociación entre la diabetes mellitus y la muerte hospitalaria por COVID-19 en Brasil, de febrero a agosto de 2020. Métodos: Estudio transversal con casos notificados como síndrome gripal en el Sistema de Información de Vigilancia de Influenza, positivos para COVID-19 y hospitalizados. La magnitud de la asociación entre diabetes y muerte se estimó mediante la regresión de Poisson con varianza robusta. Resultados: Se analizaron datos de 397.600 casos hospitalizados, de los cuales 32,0% (n = 127.231) fallecieron. La prevalencia de muerte entre las personas con diabetes fue de 40,8% (RP = 1,41; IC95% 1,39;1,42). Después de ajustar por variables sociodemográficasy comorbilidades, se observó que la muerte era 1,15 vez más frecuente entre los diabéticos (IC95% 1,14;1,15). Conclusión: 3 de cada 20 muertes por COVID-19 ocurrieron en individuos con diabetes mellitus, destacando la susceptibilidad de esta población y la necesidad de control de esta enfermedad crónica.
Objective: To analyze the association between diabetes mellitus and hospital deaths due to Covid-19 in Brazil, from February to August 2020. Methods: This was a cross-sectional study on hospitalized flu-like syndrome cases, with a positive test result for COVID-19, reported on the Influenza Epidemiological Surveillance Information System. Poisson regression with robust variance was used to estimate the magnitude of the association between diabetes and deaths. Results: Data from 397,600 hospitalized cases were analyzed, of which 32.0% (n = 127,231) died. The prevalence of death among people with diabetes was 40.8% (PR = 1.41; 95%CI 1.39;1.42). After adjustments for the variables sociodemographic and comorbidities, it could be seen that those with diabetes (95%CI 1.14;1.16) were 1.15 time more likely to die. Conclusion: 3 out of every 20 deaths due to COVID-19 occurred among individuals with diabetes mellitus, highlighting this population susceptibility and the need to control this chronic disease.
Subject(s)
Humans , Diabetes Mellitus/epidemiology , COVID-19/mortality , COVID-19/epidemiology , Hospitalization/statistics & numerical data , Brazil/epidemiology , Comorbidity , Cross-Sectional Studies , Risk Factors , Diabetes Mellitus/mortalitySubject(s)
Humans , Aged , Energy Intake , Diabetes Mellitus/epidemiology , Brazil/epidemiology , Diet , EatingABSTRACT
Objetivo: Analisar a validade, confiabilidade e interpretabilidade de instrumento reduzido para avaliação da qualidade de vida relacionada à saúde entre pessoas com diabetes mellitus. Métodos: Estudo de validação, composto pelas fases de adaptação do instrumento Diabetes-39 (constituído por 5 dimensões e 39 itens), pré-teste, análises de validade estrutural (exploratória e confirmatória), confiabilidade, validade concorrente e interpretabilidade. Resultados: A estrutura fatorial da versão final reduzida diferiu do instrumento original. Foram reduzidos os itens, de 39 para 21, e as dimensões, de 5 para 4. As cargas fatoriais, nas análises exploratória e confirmatória, variaram entre 0,41 e 0,90 e entre 0,51 e 0,89, respectivamente. A confiabilidade apresentou-se adequada (alfa de Cronbach=0,91; Kappa≥0,60 em todos os itens; coeficiente de correlação intraclasse=0,91). Conclusão: O instrumento reduzido Diabetes-21 foi considerado válido, confiável e interpretável para avaliação da qualidade de vida relacionada à saúde entre pessoas com diabetes mellitus.
Objetivo: Analizar la validez, confiabilidad y la interpretación del instrumento reducido para evaluar la calidad de vida relacionada con la salud en personas con diabetes mellitus. Métodos: Estudio de validación compuesto por las fases de: adaptación del instrumento Diabetes-39 (5 dimensiones/39 elementos), pre test, análisis de validez estructural, confiabilidad, validez concurrente y calidad de la interpretación. Resultados: La estructura factorial de la versión final del instrumento reducido fue diferente a la original. Hubo una reducción de 39 a 21 ítems y de 5 a 4 dimensiones. Las cargas factoriales en los análisis exploratorios y confirmatorios variaron entre 0,41-0,90 y 0,51-0,89, respectivamente. La fiabilidad fue adecuada (alfa de Cronbach=0,91; Kappa≥0,60 en todos los ítems; coeficiente de correlación intraclase=0,91). Conclusión: El Diabetes-21 se consideró válido, confiable e interpretable para evaluar la calidad de vida relacionada con la salud en personas con diabetes mellitus.
Objective: To analyze the validity, reliability and interpretability of a short form instrument for assessing health-related quality of life among people with diabetes mellitus. Methods: This was a validation study, comprised of the adaptation phases of the Diabetes-39 instrument (consisting of 5 domains and 39 items), pre-test, structural validity analyses (exploratory and confirmatory), reliability, concurrent validity and interpretability. Results: The factorial structure of the short final version differed from the original instrument. The items were reduced from 39 to 21 and domains from 5 to 4. The factor loading, in exploratory and confirmatory analyses, ranged between 0.41 and 0.90 and between 0.51 and 0.89, respectively. Reliability was adequate (Cronbach's alpha=0.91; Kappa≥0.60 in all items; intraclass correlation coefficient =0.91). Conclusion: Diabetes-21, a short form instrument, was considered valid, reliable and interpretable for assessing health-related quality of life among people with diabetes mellitus.
Subject(s)
Humans , Reproducibility of Results , Diabetes Mellitus/epidemiology , Quality of Life , Brazil/epidemiology , Factor Analysis, StatisticalABSTRACT
INTRODUCTION@#Identifying peripheral arterial disease (PAD) during diabetic foot screening (DFS) is crucial in reducing the risk of diabetic foot ulcerations and lower limb amputations. Screening assessments commonly used include absolute systolic toe pressure (ASTP) and toe-brachial index (TBI). There is a lack of research defining the threshold values of both assessment methods. We aimed to compare the accuracy of ASTP and TBI and establish optimal threshold values of ASTP and TBI with reference to the internationally accepted ankle-brachial pressure index (ABPI) screening test, for a multiethnic diabetic population in Singapore.@*METHODS@#A retrospective, observational study of DFS results from January 2017 to December 2017 was conducted. Receiver operating characteristic analysis was conducted for ASTP and TBI using the internationally accepted ABPI cut-off value of ≤0.9 to indicate PAD.@*RESULTS@#A total of 1,454 patients with mean (standard deviation) age of 63.1 (12.4) years old were included. There were 50.8% men and 49.2% women, comprising 69.7% Chinese, 13.5% Indian, 10.1% Malay and 6.7% other ethnicities. Areas under the curve for ASTP and TBI were 0.89 (95% confidence interval [Cl] 0.85-0.94) and 0.94 (95% Cl 0.90-0.98), respectively, and the difference was statistically significant (P<0.001). Derived optimal threshold values to indicate ABPI≤0.9 for ASTP and TBI were <95.5mmHg (specificity 0.86, sensitivity 0.84) and <0.7 (specificity 0.89, sensitivity 0.95), respectively.@*CONCLUSION@#ASTP or TBI may be used to detect ABPI-determined PAD in DFS. The optimal threshold values derived from a multiethnic Asian diabetic population were <95.5mmHg for ASTP and <0.7 for TBI.
Subject(s)
Female , Humans , Male , Middle Aged , Ankle Brachial Index/methods , Diabetes Mellitus/epidemiology , Diabetic Foot/diagnosis , Peripheral Arterial Disease/diagnosis , Retrospective Studies , ToesABSTRACT
Objective@#To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD.@*Methods@#A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD.@*Results@#The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD.@*Conclusion@#There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.
Subject(s)
Humans , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Macular Degeneration/etiology , Risk FactorsABSTRACT
To compare the performance of generalized additive model (GAM) and long short-term memory recurrent neural network (LSTM-RNN) on the prediction of daily admissions of respiratory diseases with comorbid diabetes. Daily data on air pollutants, meteorological factors and hospital admissions for respiratory diseases from Jan 1st, 2014 to Dec 31st, 2019 in Beijing were collected. LSTM-RNN was used to predict the daily admissions of respiratory diseases with comorbid diabetes, and the results were compared with those of GAM. The evaluation indexes were calculated by five-fold cross validation. Compared with the GAM, the prediction errors of LSTM-RNN were significantly lower [root mean squared error (RMSE): 21.21±3.30 vs. 46.13±7.60, <0.01; mean absolute error (MAE): 14.64±1.99 vs. 36.08±6.20, <0.01], and the value was significantly higher (0.79±0.06 vs. 0.57±0.12, <0.01). In gender stratification, RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting female admission (all <0.05), but there were no significant difference in predicting male admission between two models (all >0.05). In seasonal stratification, RMSE and MAE of LSTM-RNN were lower than those of GAM in predicting warm season admission (all <0.05), but there was no significant difference in value (>0.05). There were no significant difference in RMSE, MAE and between the two models in predicting cold season admission (all >0.05). In the stratification of functional areas, the RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting core area admission (all <0.05). has lower prediction errors and better fitting than the GAM, which can provide scientific basis for precise allocation of medical resources in polluted weather in advance.
Subject(s)
Female , Humans , Male , Beijing/epidemiology , Diabetes Mellitus/epidemiology , Hospitalization , Memory, Short-Term , Neural Networks, ComputerABSTRACT
The fracture risk of patients with diabetes is higher than those of patients without diabetes due to hyperglycemia, usage of diabetes drugs, changes in insulin levels, and excretion, and this risk begins as early as adolescence. Many factors including demographic data (such as age, height, weight, and gender), medical history (such as smoking, drinking, and menopause), and examination (such as bone mineral density, blood routine, and urine routine) may be related to bone metabolism in patients with diabetes. However, most of the existing methods are qualitative assessments and do not consider the interactions of the physiological factors of humans. In addition, the fracture risk of patients with diabetes and osteoporosis has not been further studied previously. In this paper, a hybrid model combining XGBoost with deep neural network is used to predict the fracture risk of patients with diabetes and osteoporosis, and investigate the effect of patients' physiological factors on fracture risk. A total of 147 raw input features are considered in our model. The presented model is compared with several benchmarks based on various metrics to prove its effectiveness. Moreover, the top 18 influencing factors of fracture risks of patients with diabetes are determined.
Subject(s)
Female , Humans , Bone Density , Deep Learning , Diabetes Mellitus/epidemiology , Fractures, Bone/etiology , Osteoporosis/complications , Risk FactorsABSTRACT
O objetivo foi avaliar a influência do sono e da crononutrição na hipertensão e diabetes na população adulta (18 anos ou mais) em um município do Sul do Brasil. Trata-se de um estudo transversal de base populacional, desenvolvido em Criciúma, Santa Catarina, em 2019. As variáveis de exposição foram duração e qualidade do sono, e dois dos principais aspectos da crononutrição, o número de refeições diárias e a realização do café da manhã. Os desfechos estudados foram diabetes mellitus e hipertensão arterial sistêmica. Regressão de Poisson bruta e ajustada com variância robusta foi utilizada para avaliar as associações entre as exposições e os desfechos. Para todas as análises, considerou-se o efeito do desenho amostral, e o nível de significância utilizado foi de 5%. Foram estudados 820 indivíduos. As prevalências de diabetes e hipertensão foram 19,9% e 44,1%, respectivamente. Indivíduos com pior qualidade do sono tiveram prevalência 33% maior de diabetes e 17% maior de hipertensão, comparados àqueles com boa qualidade do sono. Os que realizaram quatro ou mais refeições ao dia apresentaram prevalência 16% menor de hipertensão quando comparados aos que fizeram menos de quatro refeições. Conclui-se que a qualidade do sono e o número de refeições diárias, um comportamento alimentar relacionado à crononutrição, estiveram relacionados à hipertensão e ao diabetes. Tais resultados destacam a importância de ações de saúde pública que abordem novas estratégias para o enfrentamento dessas doenças, voltadas à qualidade do sono e à crononutrição.
The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.
El objetivo fue evaluar la influencia del sueño y la crononutrición sobre la hipertensión arterial y la diabetes en la población adulta (18 años o más) en un municipio del Sur de Brasil. Se trata de un estudio transversal de base poblacional, desarrollado en Criciúma, Santa Catarina, en el 2019. Las variables de exposición fueron la duración y la calidad del sueño, y dos de los principales aspectos de la crononutrición, el número de comidas diarias y el consumo de desayuno. Los desenlaces estudiados fueron la diabetes mellitus e la hipertensión arterial sistémica. Se utilizó la regresión de Poisson cruda y ajustada con varianza robusta para evaluar las asociaciones entre las exposiciones y los desenlaces. Para todos los análisis, se consideró el efecto del diseño de la muestra y el nivel de significación utilizado fue del 5%. Se estudiaron 820 individuos. Las prevalencias de diabetes e hipertensión fueron de 19,9% y del 44,1%, respectivamente. Las personas con peor calidad del sueño tuvieron una prevalencia de diabetes un 33% mayor y una prevalencia de hipertensión un 17% mayor, en comparación con las personas con una buena calidad del sueño. Los que efectuaron cuatro o más comidas al día presentaron una prevalencia de hipertensión un 16% menor en comparación con los que efectuaron menos de cuatro comidas. Se concluye que la calidad del sueño y el número de comidas diarias, una conducta alimentaria relacionada con la crononutrición, están relacionados con la hipertensión arterial y la diabetes. Estos resultados destacan la importancia de acciones de salud pública que aborden nuevas estrategias de enfrentamiento a estas enfermedades, centradas en la calidad del sueño y en la crononutrición.