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   2010| June-September  | Volume 1 | Issue 2  
    Online since January 5, 2017

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Androgen Deprivation Therapy Increases the Risk of Diabetes and Non - cancer Mortality in Prostate Cancer patients: A Meta- analysis
MA Tunio, M Rafi, A Qayyum, A Hashmi
June-September 2010, 1(2):5-5
Androgen deprivation therapy (ADT) with Luteinizing hormone releasing hormone analogues or bilateral subcapsular orchiectomy is the mainstay of treatment in high risk localized and metastatic prostate cancer along with other modalities. ADT is associated with increased fat mass and insulin resistance, but the risk of incident diabetes and non-cancer mortality during this treatment has not been well studied. We conducted a meta-analysis to see whether androgen deprivation therapy is associated with an increased incidence of diabetes and cardiovascular diseases. The MEDLINE, CANCERLIT, COCHRANE library database, and the search engines, were searched to identify, prospective, randomized, controlled studies in prostate cancer patients receiving short, long term or no ADT and risk of incident diabetes and non cancer mortality. Comprehensive Meta-analysis software version 2.0 was used for the analysis. Four prospective trials with a total patient population of 1, 15,119 were identified. Pooled results from these trials showed an increase d risk of diabetes in patients treated with long term ADT (p= 0.0001) as well as increased non -cancer mortality (Odds ratio 1.69; p < 0.001. Main cause of non-cancer death was sudden cardiac death (SCD). The resultant funnel plot of meta- analysis showed lack of publication bias. This meta-analysis shows increased risk of diabetes and cardiovascular diseases in prostate cancer patient on long term androgen deprivation therapy; already existing diabetes also deteriorated. The results of this study warrants active surveillance of patients on androgen deprivation therapy.
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Association between food patterns and metabolic syndrome in China
Z Shi, X Hu, B Yuan, G Hu, X Pan, Y Dai, G Holmboe-Ottesen, J Byles
June-September 2010, 1(2):1-1
The objective of this paper is to investigate the association between a vegetable rich food pattern and the metabolic syndrome among Chinese adults. A cross-sectional household survey of 2849 men and women aged 20 years and over was undertaken in 2002 in Jiangsu Province (response rate 89.0%). Nine hundred fifty six participants free from metabolic syndrome in 2002 participated in a follow up survey in 2007. At baseline, food intake was assessed by food frequency questionnaire. Factor analysis was used to identify food patterns. Food intake was measured by food weighing plus consecutive individual 3 day food records. Height, weight and any individual components of the metabolic syndrome were measured both in 2002 and 2007. The prevalence of metabolic syndrome by the modified ATP III definition was 12.9% in men and 19.6% in women. A four-factor solution explained 30.5% of the total variance in food frequency intake. The 'vegetable rich' food pattern (whole grains, fruits and vegetables) was positively associated with vegetable oil and energy intake in both genders. Prevalence of metabolic syndrome increased across the quartiles of 'vegetable rich' food pattern. After adjusting for socio-demographic and other three distinct food patterns, the 'vegetable rich' pattern was independently associated with metabolic syndrome at baseline. Compared with the lowest quartile (Q1) of 'vegetable rich' pattern, the highest quartile (Q4) had a higher risk of metabolic syndrome (men: odds ratio [OR]: 1.68, 95% confidence interval [CI] 1.02-2.79; women: OR: 1.75, 95%CI 1.17-2.62). The 'vegetable rich' food pattern was also positively associated with incident metabolic syndrome among women in 2007. The healthfulness of 'vegetable rich' food pattern is dependent on variety and amounts of other foods used and total intake of energy and various nutrients.
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Type 2 Diabetes and obesity: A review
A Hussain, M.Z.I . Hydrie, B Claussen, S Asghar
June-September 2010, 1(2):4-4
The article reviews the relationship between type 2 diabetes and obesity. This also includes types of obesity and its genetic predisposition. The modern generalization of sedentary life and caloric abundance has created new physiological conditions capable of changing the level of expression of a number of genes involved in fuel metabolism and body weight regulation. It is likely that the genetic variants or alleles of these genes have in the past participated in the adaptation of human physiology to its evolutionary constraints. In this article, we underscore the importance of obesity in relation to disorders of diverse etiologies characterized by disturbances of free fatty acids, visceral adiposity and insulin resistance. Further, we have investigated the role of selecting the traits to be subjected to quantitative genetic analysis in the occurrence of obesity
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Introducing physical activity to type 2 Diabetes Mellitus patients and those at risk: learning points from the Netherlands
M Hopman- Rock, M.W.A. Jongert, A.T.H. Van-Hespen, A.M.J. Chorus
June-September 2010, 1(2):2-2
Type 2 Diabetes Mellitus (DM) is one of the major diseases for which strong evidence exists that physical activity prevents onset and may counteract progress. However, it is not so easy to change physical activity behaviour in people that are usually inactive. As type 2 DM has a high incidence and prevalence in the Netherlands, it has been chosen as a priority for a national effort called "De Beweegkuur" (based on the idea of Exercise on prescription). It is known that tailored exercise counseling is most helpful. However, it will be more (cost) effective if only a few profiles exist in which patients could be divided and treated. The first aim was developing such patient profiles. The second aim was to get an impression of how "De Beweegkuur" meets the possibilities of general practitioners (GPs) and physiotherapists and how the profiles could be handled by them. Therefore a qualitative study was performed. Information from an internet literature search and some patient focus group interviews was used as basis for a consensus meeting to formulate criteria for patient profiles. Eleven GPs and 38 physiotherapists were interviewed about existing practices, attitudes, and barriers to change. Three different patient profiles were developed. GPs saw type 2 DM patients and those at risk four times a year on average. According to these GPs, barriers for patients to change their physical activity were: cost (programmes are not yet in health insurance), anxious to exercise because of fatigue, and overweight. Physiotherapists who deliver programmes complain that GPs are not very willing to prescribe physical activity and to let their patients join special programmes from "De Beweegkuur". It is recommended to use the newly developed patient profiles to make it easier for the GPs and physiotherapist s to divide patients in sub groups. This will enhance a more tailor-made guidance through the existing PA stimulating programme possibilities that are referred to "De Beweegkuur". Also, local cooperation between professionals should be improved
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Assessment of the risk for metabolic syndrome in prediabetes and newly-diagnosed type 2 diabetes
TI Tankova, NY Chakarova, LN Dakovska, KB Kalinov, IA Atanassova
June-September 2010, 1(2):3-3
The aim of the present study was to assess the risk for metabolic syndrome (MetS) in subjects with pre- diabetes - impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and in newly- diagnosed type 2 diabetes (NDD). The metabolic syndrome parameters (according to 2005 IDF definition) and high-sensitive C-reactive protein (hsCRP) were measured in 727 subjects - 238 with IFG, 184 with IGT and 305 with NDD. The unadjusted prevalence of MetS was 84.03% in IFG, 89.13% in IGT and 89.51% in NDD. The odds ratio (OR) for prevalent MetS was 8.82 (95% CI, 3.19 -19.8, p<0.001) in IFG, 11.26 (95% CI, 4.18 -24.6, p<0.001) in IGT and 4.87 (95% CI, 2.10 -9.50, p<0.001) in NDD. Of the different studied parameters, the OR for metabolic syndrome was significant for female sex - 2.31 (95% CI, 1.45-4.35, p=0.009), fasting plasma glucose - 2.30 (95% CI, 1.56 -3.40, p<0.001), waist circumference - 1.36 (95% CI, 1.12-1.42, p<0.001), HDL -cholesterol - 0.273 (95% CI, 0.14-0.52, p=0.01) and triglycerides - 3.84 (95% CI, 2.61-5.66, p<0.0001). Significantly higher hsCRP level s were found in all groups with MetS as compared to those without MetS. The prevalence of MetS in pre-diabetes is rather high, being similar to that in newly-diagnosed type 2 diabetes. The risk for MetS is even higher in pre-diabetes as compared to NDD. Therefore IFG and IGT should be considered not just as conditions of altered glucose metabolism but also in relation to their association with cardiovascular risk factors.
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