Browsing by Author "Andersen, L. B."
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- Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participantsPublication . Danaei, G; Fahimi, S; Lu, Y; Zhou, B; Hajifathalian, K; Di Cesare, M; Lo, WC; Reis-Santos, B; Cowan, MJ; Shaw, JE; Bentham, J; Mohammad, K; Mohan, V; Mohd Yusoff, MF; Møller, NC; Molnár, D; Aguilar-Salinas, CA; Mondo, CK; Moreno, LA; Morgan, K; El Ati, J; Jonas, JB; Moschonis, G; Mossakowska, M; Mostafa, A; Mota, J; Muiesan, ML; Müller-Nurasyid, M; Mursu, J; Ahmadvand, A; Nagel, G; Námešná, J; Joshi, P; Elosua, R; Nang, EE; Nangia, VB; Navarrete-Muñoz, EM; Ndiaye, NC; Nervi, F; Nguyen, ND; Nieto-Martínez, RE; Alvarado, L; Al Nsour, M; Kafatos, A; Ning, G; Lin, JK; Ninomiya, T; Noale, M; Noto, D; Ochoa-Avilés, M; Oh, K; Onat, A; Osmond, C; Otero, JA; Kalter-Leibovici, O; Palmieri, L; Alkerwi, A; Erasmus, RT; Panda-Jonas, S; Panza, F; Parsaeian, M; Peixoto, SV; Pereira, AC; Peters, A; Peykari, N; Kasaeian, A; Pilav, A; Pitakaka, F; Piwonska, A; Erem, C; Amouyel, P; Piwonski, J; Plans-Rubió, P; Porta, M; Portegies, ML; Poustchi, H; Katz, J; Pradeepa, R; Price, JF; Punab, M; Qasrawi, RF; Ergor, G; Qorbani, M; Andersen, L. B.; Raitakari, O; Ramachandra Rao, S; Ramachandran, A; Kaur, P; Ramos, R; Rampal, S; Rathmann, W; Redon, J; Reganit, PF; Eriksen, L; Rigo, F; Robinson, SM; Anderssen, S. A.; Robitaille, C; Kavousi, M; Rodríguez, LA; Rodríguez-Artalejo, F; del Cristo Rodriguez-Perez, M; Rojas-Martinez, R; Romaguera, D; Rosengren, A; Escobedo-de la Peña, J; Rubinstein, A; Ornelas, Rui; Ruiz-Betancourt, BS; Kelishadi, R; Andrade, DS; Rutkowski, M; Sabanayagam, C; Sachdev, HS; Saidi, O; Sakarya, S; Salanave, B; Fall, CH; Salonen, JT; Salvetti, M; Ali, MK; Sánchez-Abanto, J; Santos, RN; Anjana, RM; Santos, R; Sardinha, LB; Scazufca, M; Schargrodsky, H; Scheidt-Nave, C; Farzadfar, F; Shaw, JE; Dhana, K; Shibuya, K; Shin, Y; Shiri, R; Siantar, R; Aounallah-Skhiri, H; Sibai, AM; Simon, M; Simons, J; Simons, LA; Felix-Redondo, FJ; Kengne, AP; Sjostrom, M; Slowikowska-Hilczer, J; Slusarczyk, P; Smeeth, L; Snijder, MB; Solfrizzi, V; Aris, T; Sonestedt, E; Soumare, A; Staessen, JA; Kersting, M; Ferguson, TS; Steene-Johannessen, J; Stehle, P; Stein, AD; Stessman, J; Stöckl, D; Stokwiszewski, J; Strufaldi, MW; Arlappa, N; Sun, CA; Khader, YS; Sundström, J; Fernández-Bergés, D; Suriyawongpaisal, P; Sy, RG; Tai, ES; Tarawneh, M; Tarqui-Mamani, CB; Thijs, L; Tolstrup, JS; Topbas, M; Khang, YH; Arveiler, D; Torrent, M; Bixby, H; Traissac, P; Trinh, OT; Tulloch-Reid, MK; Tuomainen, TP; Turley, ML; Tzourio, C; Ueda, P; Kiechl, S; Ukoli, FM; Ulmer, H; Assah, FK; Ferrari, M; Valdivia, G; van Valkengoed, IG; Vanderschueren, D; Vanuzzo, D; Vega, T; Velasquez-Melendez, G; Kim, J; Veronesi, G; Verschuren, M; Vioque, J; Virtanen, J; Ferreccio, C; Avdicová, M; Visvikis-Siest, S; Viswanathan, B; Vollenweider, P; Voutilainen, S; Kiyohara, Y; Wade, AN; Wagner, A; Walton, J; Mohamud, WN; Wang, MD; Finn, JD; Wang, YX; Balakrishna, N; Wannamethee, SG; Weerasekera, D; Kolsteren, P; Whincup, PH; Widhalm, K; Wiecek, A; Wilks, RJ; Willeit, J; Wojtyniak, B; Föger, B; Wong, TY; Woo, J; Bandosz, P; Korrovits, P; Woodward, M; Wu, AG; Wu, FC; Wu, SL; Xu, H; Yang, X; Ye, X; Foo, LH; Yoshihara, A; Younger-Coleman, NO; Koskinen, S; Zambon, S; Barbagallo, CM; Zargar, AH; Zdrojewski, T; Zhao, W; Zheng, Y; Barceló, A; Batieha, AM; Fouad, HM; Baur, LA; Di Castelnuovo, AF; Ben Romdhane, H; Bernabe-Ortiz, A; Bhargava, SK; Bi, Y; Bjerregaard, P; Björkelund, C; Blake, M; Blokstra, A; Bo, S; Francis, DK; Ezzati, M; Boehm, BO; Boissonnet, CP; Bovet, P; Brajkovich, I; Breckenkamp, J; Brewster, LM; Brian, GR; Bruno, G; Bugge, A; Cabrera de León, A; Kratzer, W; Franco Mdo, C; Can, G; Cândido, AP; Capuano, V; Carvalho, M. J.; Casanueva, FF; Caserta, CA; Castetbon, K; Chamukuttan, S; Chaturvedi, N; Kromhout, D; Chen, CJ; Frontera, G; Chen, F; Chen, S; Cheng, CY; Chetrit, A; Chiou, ST; Cho, Y; Chudek, J; Cifkova, R; Kula, K; Claessens, F; Concin, H; Furusawa, T; Cooper, C; Cooper, R; Costanzo, S; Cottel, D; Cowell, C; Crujeiras, AB; D'Arrigo, G; Kurjata, P; Dallongeville, J; Dankner, R; Dauchet, L; Magliano, D; de Gaetano, G; De Henauw, S; Deepa, M; Dehghan, A; Gaciong, Z; Galbarczyk, A; Kyobutungi, C; Garnett, SP; Gaspoz, JM; Gasull, M; Gates, L; Geleijnse, JM; Ghasemain, A; Giampaoli, S; Gianfagna, F; Bovet, P; Giovannelli, J; Lachat, C; Gonzalez Gross, M; González Rivas, JP; Gorbea, MB; Gottrand, F; Grant, JF; Grodzicki, T; Grøntved, A; Gruden, G; Gu, D; Miranda, JJ; Laid, Y; Guan, OP; Guerrero, R; Guessous, I; Guimaraes, AL; Gutierrez, L; Hardy, R; Hari Kumar, R; Heidemann, C; Hihtaniemi, IT; Ho, SY; Lam, TH; Khang, YH; Ho, SC; Hofman, A; Horimoto, AR; Hormiga, CM; Horta, BL; Houti, L; Hussieni, AS; Huybrechts, I; Hwalla, N; Lanska, V; Iacoviello, L; Stevens, GA; Iannone, AG; Ibrahim, MM; Ikeda, N; Ikram, MA; Irazola, VE; Islam, M; Iwasaki, M; Jacobs, JM; Djalalinia, S; Jafar, T; Jasienska, G; Riley, LM; Jiang, CQ; Lappas, G; Abdeen, ZA; Laxmaiah, A; Leclercq, C; Lee, J; Lee, J; Lehtimäki, T; Lekhraj, R; León-Muñoz, LM; Li, Y; Doua, K; Lim, WY; Lima-Costa, MF; Kadir, KA; Lin, HH; Lin, X; Lissner, L; Lorbeer, R; Lozano, JE; Lundqvist, A; Lytsy, P; Drygas, W; Ma, G; Machado-Coelho, GL; Machi, S; Abu-Rmeileh, M; Maggi, S; Magliano, D; Makdisse, M; Mallikharjuna v, K; Manios, Y; Manzato, E; Du, Y; Margozzini, P; Marques-Vidal, P; Martorell, R; Masoodi, SR; Acosta-Cazares, B; Matsha, TE; Mbanya, JC; McFarlane, SR; McGarvey, ST; McLachlan, S; Egbagbe, EE; McNulty, BA; Mediene-Benchekor, S; Meirhaeghe, A; Menezes, AM; Merat, S; Aekplakorn, W; Meshram, II; Mi, J; Miquel, JF; Miranda, JJ; Eggertsen, R; Mohamed, MKBackground Diabetes has been defi ned on the basis of diff erent biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the eff ect of diff erent diagnostic defi nitions on both the population prevalence of diabetes and the classifi cation of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in diff erent regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defi ning diabetes. Diabetes was defi ned using HbA1c (HbA1c ≥6·5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT defi nitions (FPG ≥7·0 mmol/L or 2hOGTT ≥11·1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using diff erent defi nitions graphically and by regression analyses. We calculated sensitivity and specifi city of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specifi city in each survey, and then pooled results using a random-eff ects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG-or-2hOGTT was correlated with prevalence based on FPG alone (r=0·98), but was higher by 2–6 percentage points at diff erent prevalence levels. Prevalence based on HbA1c was lower than prevalence based on FPG in 42·8% of age–sex–survey groups and higher in another 41·6%; in the other 15·6%, the two defi nitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA1c-based prevalences was partly related to participants’ age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specifi c communities. Diabetes defi ned as HbA1c 6·5% or more had a pooled sensitivity of 52·8% (95% CI 51·3–54·3%) and a pooled specifi city of 99·74% (99·71–99·78%) compared with FPG 7·0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defi ned based on FPG or-2hOGTT was 30·5% (28·7–32·3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA1c versus FPG. Interpretation Diff erent biomarkers and defi nitions for diabetes can provide diff erent estimates of population prevalence of diabetes, and diff erentially identify people without previous diagnosis as having diabetes. Using an HbA1c-based defi nition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
- Objectively measured time spent sedentary is associated with insulin resistance independent of overall and central body fat in 9-to 10-year-old portuguese childrenPublication . Sardinha, L. B.; Andersen, L. B.; Anderssen, S. A.; Quiterio, A. L.; Ornelas, Rui; Froberg, K.; Riddoch, C. J.; Ekelund, U.OBJECTIVE — We examined the independent relationships between objectively measured physical activity and insulin resistance in Portuguese children. RESEARCH DESIGN AND METHODS — This is a school-based, cross-sectional study in 147 randomly selected girls (aged 9.8 0.3 years; 27.8 9.3% body fat) and 161 boys (aged 9.8 0.3 years; 22.0 9.2% body fat). Physical activity was assessed by the Actigraph accel erometer for 4 days and summarized as time spent sedentary (accelerometer counts 500/min), in light-intensity (accelerometer counts 500–2,000/min), and in moderate- and vigorous intensity activity (accelerometer counts 2,001/min). We measured total and central fat mass by dual-energy X-ray absorptiometry. Insulin resistance was expressed as the homeostasis model assessment score. RESULTS — Time (min/day) spent sedentary was significantly and positively associated with insulin resistance ( -coefficient 0.001 [95% CI 0.0002–0.002]; P 0.013). Time spent in moderate- and vigorous-intensity physical activity ( 0.002 [ 0.003 to 0.001]; P 0.0009) and overall physical activity ( 0.001 [ 0.008 to 0.003]; P 0.0001) were significantly and inversely associated with insulin resistance. All associations remained statistically significant, although they were attenuated after further adjustments for sex, birth weight, sexual maturity, and total or central fat mass (P 0.03). CONCLUSIONS — Physical activity is associated with insulin resistance independent of total and central fat mass in children. Our results emphasize the importance of decreasing sedentary behavior and increasing time spent in moderate- and vigorous-intensity activity in children, which may have beneficial effects on metabolic risk factors regardless of the degree of adiposity.