Trends in depression by glycemic status: Serial cross-sectional analyses of the National Health and Nutrition Examination Surveys, 2005–2016

AimsWe examined changes in the prevalence of elevated depressive symptoms among US adults with diabetes, prediabetes, and normal glycemic status during 2005–2016.MethodsWe analyzed data from 32,676 adults in the 2005–2016 National Health and Nutrition Examination Surveys. We defined diabetes as self-reporting a physician diagnosis of diabetes or A1C ≥ 6.5% [48 mmol/mol], and prediabetes as A1C 5.7–6.4% [39–46 mmol/mol]. We used the 9-item Patient Health Questionnaire (PHQ-9) score ≥ 10 or antidepressant use to define ‘clinically significant depressive symptoms’ (CSDS) and PHQ-9 score ≥ 12 as ‘Major Depressive Disorder’ (MDD). We calculated prevalence age-standardized to the 2000 US census and used logistic-regression to compute adjusted odds of CSDS and MDD for 2005–2008, 2009–2012, and 2015–2016. We analyzed the prevalence of A1C ≥ 9.0% [75 mmol/mol], systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, non-HDL cholesterol ≥ 130 mg/dL, and current smoking among adults with diagnosed diabetes by depressive status.ResultsThe prevalence of CSDS increased among individuals with normal glycemic status from 15.0% (13.5–16.2) to 17.3% (16.0–18.7) (p = 0.03) over 2005–2016. The prevalence of CSDS and MDD remained stable among adults with prediabetes (~ 16% and 1%, respectively) and diabetes (~ 26% and ~3%). After controlling for glycemic, sociodemographic, economic, and self-rated health variables, we found 2-fold greater odds of CSDS among unemployed individuals and 3-fold greater odds among those with fair/poor self-rated health across all survey periods. Cardiometabolic care targets for adults with diagnosed diabetes were stable from 2005 to 2016 and similar across depressive status.ConclusionsOne-fourth of adults with diabetes have comorbid CSDS; this prevalence remained stable over 2005–2016 with no change in diabetes care. At the population level, depression does not appear to impact diabetes care, but further research could explore subgroups that may be more vulnerable and could benefit from integrated care that addresses both conditions.     

Women’s household decision-making autonomy and safer sex negotiation in Nigeria: An analysis of the Nigeria Demographic and Health Survey

Although married women’s safer sex negotiation with their husbands is critical in reducing new HIV infections in Nigeria, its linkage to women’s household decision-making autonomy is less explored in Nigeria. Drawing data from the 2013 Nigeria Demographic and Health Survey and using the logistic regression technique, we examined the associations between women’s household decision-making autonomy and two indicators of the ability to engage in safer sex including whether married women 1) can refuse sex and 2) ask for condom use during sexual intercourse with husbands. Findings indicate that 64% and 41% of married women can refuse sex and ask for condom use, respectively. While the impact of women’s household decision-making autonomy on the ability to refuse sex remained statistically significant after controlling for theoretically relevant variables (OR?=?1.15; p?p?相似文献   

The relationship between bone mineral density and blood pressure in the Korean elderly population: the Korea National Health and Nutrition Examination Survey, 2008–2011

Abstract

It is not clear whether the inverse relationship between bone mineral density (BMD) and blood pressure (BP) could be generalizable to the general elderly population. We used data from the fourth and fifth Korea National Health and Nutrition Examination Survey. The study sample consisted of 8439 men and postmenopausal women aged 50 years and older. We evaluated the relationship between BMD and BP. When adjusted for covariates, femur neck T-score [coefficient?=??0.391, 95% confidence interval (CI) ?0.766 to ?0.016, p?=?0.041] had an inverse relationship with diastolic BP (DBP), whereas lumbar spine BMD (coefficient?=?0.395, 95% CI 0.058–7.752, p?=?0.047) and T-score (coefficient?=?0.458, 95% CI 0.005–0.911, p?=?0.047) had a positive relationship with systolic BP (SBP). When adjusted for confounding factors, SBP (128.67?±?0.979?mmHg versus 126.36?±?0.545?mmHg, p?=?0.026) and DBP (78.8?±?0.622?mmHg versus 77.27?±?0.283?mmHg, p?=?0.016) were significantly higher in femur neck osteoporosis subjects than non-osteoporosis subjects. However, there were no differences in BP in relation to lumbar spine osteoporosis. Femur neck osteoporosis (odds ratio?=?1.422, 95% CI 1.107–1.827, p?=?0.006) had a significant and positive relationship with hypertension, whereas the other parameters of BMD were not significantly related to hypertension. In conclusion, higher BP and hypertension were significantly and positively correlated with femur neck osteoporosis in men and postmenopausal women aged 50 years and older.     

Metabolically healthy and unhealthy weight statuses,health issues and related costs: Findings from the 2013–2015 European Health Examination Survey in Luxembourg

AimTo investigate the relationship between metabolically healthy and unhealthy weight statuses and a wide range of related health issues, and healthcare and loss-of-productivity costs.MethodsA total of 693 men and 729 women, aged 25–64 years, took part in the European Health Examination Survey conducted in Luxembourg between 2013 and 2015. Metabolically unhealthy normal-weight profiles were defined as having two or more cardiometabolic abnormalities (high blood pressure, high fasting glucose or triglycerides, low HDL cholesterol and/or previously diagnosed hypertension or diabetes) in people with normal weight. Metabolically healthy overweight/obesity was defined as having fewer than two of the above-mentioned abnormalities in people with overweight or obesity. For the present report, the participants’ anthropometric, clinical, biological, sociodemographic, lifestyle and health-related data were analyzed.ResultsOf the participants with normal weight, 20% had a metabolically unhealthy profile, whereas 60% with overweight and 30% with obesity had a metabolically healthy profile. Comparisons between metabolically healthy and unhealthy normal weight, overweight and/or obesity status revealed that participants presented with a metabolically unhealthy profile independently of weight status (P < 0.0001). People with a metabolically healthy profile were more likely to perceive their health as good (66%; P < 0.0001), and to report no physical pain (64%; P = 0.03), no limitations in daily activities (66%; P = 0.0008), no difficulties getting in or out of a bed or chair (63%; P = 0.02) or dressing and undressing (63%; P = 0.003), going shopping (63%; P = 0.053) or doing occasional heavy housework (64%; P = 0.007); they also displayed fewer gastrointestinal (63%; P = 0.02), arthrosis (64%; P = 0.001) and sleep apnoea issues (63%; P = 0.002) compared with those with a metabolically unhealthy profile. Healthcare- and loss-of-productivity-related costs were higher with a metabolically unhealthy profile, with differences of up to € 3000 (P = 0.02).ConclusionThe present work has highlighted that, independently of weight status, people may develop a metabolically unhealthy profile associated with several health issues as well as higher healthcare and loss-of-productivity costs.     

A longitudinal study of blood pressure in the Japanese, 1958–1972

Blood pressure data with related medical and demographic information from a longitudinal study of a Japanese cohort are presented. The role of suspected hypertension risk factors including age. sex, initial pressure levels and body weight in determining the probability of further pressure elevation was examined. Only a minority of mild hypertensives progressed into the ‘severe’ category during the decade under study, with initial pressures and age being of greatest predictive importance. Despite a relationship between weight and blood pressure, and although a general increase in body stature was observed, mean pressures were not seen to rise as predicted among individuals of a given age group in the early 1970's when compared to subjects of the same age a decade earlier. There was a distinct excess risk for subsequent pressure rise among those with transient early ‘labile hypertension’. While there was a correlation between blood pressure and both weight and cardiovascular mortality, excess weight did not appear to have an independent effect upon the latter.     

Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15–24 years in Zambia: An in-depth analysis of the 2001–2002 and 2007 Zambia Demographic and Health Surveys

Abstract

HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001–2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15–24 years in Zambia increased significantly by 15.2% (p?=?.000) and 5.9% (p?=?.001) respectively, between 2001–2002 and 2007. A statistically significant increase of 6.6% (p =?.029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p?=?.000) and 1.4% (p?=?.000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15–24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (?4.5%), premarital sex (?2.6%), sex before age 18 (?2.4%) and proportion reporting multiple partnerships (?1.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the spread of HIV and AIDS, particularly among young people in Zambia and other sub-Saharan countries.     

Association between asthma and headache: Findings from the NHANES 2001–2004

Introduction

With the adjustment of sociodemographic factors, our study aimed to explore the association between asthma control and headache using a representative sample in the United States.

Methods

A total of participants aged >20 years from the National Health and Nutrition Examination Survey (NHANES) cycles 2001–2004 were included. The presence of asthma and headache was determined by questionnaires. Multivariate logistic regression was performed.

Results

Participants with asthma had higher odds of suffering headaches (odds ratio = 1.62, 95% confidence interval: 1.30–2.02, p < 0.001). Those who had an asthma attack in the past year had higher odds of experiencing headaches than those who did not (odds ratio = 1.94, 95% confidence interval: 1.11–3.39, p = 0.022). No statistically significant association was found between participants who had emergency care visit for asthma in the past year and those who had not.

Conclusion

Patients with asthma attack in the past year were more likely to have a headache than those who without.     

SARS-CoV-2 seroprevalence and implications for population immunity: Evidence from two Health and Demographic Surveillance System sites in Kenya,February–December 2022

Background

We sought to estimate SARS-CoV-2 antibody seroprevalence within representative samples of the Kenyan population during the third year of the COVID-19 pandemic and the second year of COVID-19 vaccine use.

Methods

We conducted cross-sectional serosurveys among randomly selected, age-stratified samples of Health and Demographic Surveillance System (HDSS) residents in Kilifi and Nairobi. Anti-spike (anti-S) immunoglobulin G (IgG) serostatus was measured using a validated in-house ELISA and antibody concentrations estimated with reference to the WHO International Standard for anti-SARS-CoV-2 immunoglobulin.

Results

HDSS residents were sampled in February–June 2022 (Kilifi HDSS N = 852; Nairobi Urban HDSS N = 851) and in August–December 2022 (N = 850 for both sites). Population-weighted coverage for ≥1 doses of COVID-19 vaccine were 11.1% (9.1–13.2%) among Kilifi HDSS residents by November 2022 and 34.2% (30.7–37.6%) among Nairobi Urban HDSS residents by December 2022. Population-weighted anti-S IgG seroprevalence among Kilifi HDSS residents increased from 69.1% (65.8–72.3%) by May 2022 to 77.4% (74.4–80.2%) by November 2022. Within the Nairobi Urban HDSS, seroprevalence by June 2022 was 88.5% (86.1–90.6%), comparable with seroprevalence by December 2022 (92.2%; 90.2–93.9%). For both surveys, seroprevalence was significantly lower among Kilifi HDSS residents than among Nairobi Urban HDSS residents, as were antibody concentrations (p < 0.001).

Conclusion

More than 70% of Kilifi residents and 90% of Nairobi residents were seropositive for anti-S IgG by the end of 2022. There is a potential immunity gap in rural Kenya; implementation of interventions to improve COVID-19 vaccine uptake among sub-groups at increased risk of severe COVID-19 in rural settings is recommended.     

The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement,diagnosis and assessment of risk

OBJECTIVE:

To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.

OPTIONS AND OUTCOMES:

The diagnosis of hypertension is dependent on appropriate blood pressure measurement, the timely assessment of serially elevated readings, the degree of blood pressure elevation, the method of measurement (office, ambulatory, home) and associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk and determine the urgency, intensity and type of treatment required.

EVIDENCE:

MEDLINE searches were conducted from November 2007 to October 2008 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed full-text articles only.

RECOMMENDATIONS:

Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Key messages include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of global risk assessment and the need for ongoing monitoring of hypertensive patients to identify incident type 2 diabetes.

VALIDATION:

All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations were required to be supported by at least 70% of task force members. These guidelines will continue to be updated annually.     

National Patterns in Diabetes Screening: Data from the National Health and Nutrition Examination Survey (NHANES) 2005–2012

BACKGROUND

There are few current population-based estimates of the patterns of diabetes screening in the United States. The American Diabetes Association (ADA) recommends universal screening of adults ≥ 45 years, and high-risk adults < 45 years, but there is no current assessment of ADA guideline performance in detecting diabetes and prediabetes. Furthermore, data on racial/ethnic patterns of screening are limited.

OBJECTIVE

Our aim was to estimate diabetes screening prevalence for the US adult population and specifically for those who meet ADA criteria; to report the prevalence of prediabetes and diabetes among these groups; and to determine if high-risk race/ethnicity was associated with reported screening.

DESIGN

This was a Cross-sectional survey.

PARTICIPANTS

Non-pregnant adults (≥ 21 years) without diabetes or prediabetes who participated in the National Health and Nutrition Examination Survey (NHANES) in 2005–2012 (n = 17,572) were included in the study. “Screening-recommended” participants, classified by ADA criteria, included (1) adults ≥ 45 years and (2) “high-risk” adults < 45 years. “Screening-not-recommended” participants were adults < 45 years who did not meet criteria.

MAIN MEASURES

Diabetes screening status was obtained by self-report. We used calibrated HbA_1c and/or fasting glucose levels to define undiagnosed diabetes and prediabetes.

KEY RESULTS

Seventy-six percent of the study population (approximately 136 million US adults) met ADA criteria. Among them, less than half (46.2 %) reported screening; undiagnosed diabetes affected 3.7 % (5 million individuals), and undiagnosed prediabetes affected 36.3 % (49 million people.) African Americans were more likely to report screening, both among adults ≥ 45 years and among “high risk” younger adults (OR 1.27 and 1.36, respectively.) Hispanic participants were also more likely to report screening (OR 1.31 for older adults, 1.42 for younger adults.) The screening rate among “screening-not-recommended” adults was 29.6 %; the prevalence of diabetes and prediabetes were 0.4 and 10.2 %, respectively.

CONCLUSIONS

In a nationally representative sample, 76 % of adults met ADA screening criteria, of whom fewer than half reported screening. Limitations include cross-sectional design and screening self-report.KEY WORDS: diabetes screening, prediabetes, NHANES, ADA, disparities     

10-year risk for atherosclerotic cardiovascular disease and coronary heart disease among Korean adults: Findings from the Korean National Health and Nutrition Examination Survey 2009–2010

Background

This study examined the distribution of the 10-year risk for development of atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD), and the proportion of participants eligible for lipid management, in the Korean population.

Methods

The risk was estimated using the Pooled Cohort Equations for non-Hispanic Whites and the Adult Treatment Panel (ATP) III equations. Eligibility for lipid-lowering treatment was assessed using the American College of Cardiology/American Heart Association Blood Cholesterol Guideline and the ATP III recommendation. Complex sampling design and area under the receiver operator characteristic curve (AUC) were used.

Results

Among 7594 ASCVD-free Korean adults, aged 40–79 years, 31.3% (men, 44.1%; women, 19%) had a 10-year risk for an ASCVD event of ≥ 7.5%, and 27.1% (men, 39.4%; women, 15.2%) had a 10-year risk for a CHD event of ≥ 10%. These proportions differed according to age groups, ranging from 6.1 to 91.9% and 8.7 to 58.7% for patients in their 40s–70s, using the ASCVD and CHD risk estimations, respectively. Overall, 78.7% of individuals remain in the same risk stratum. Those eligible for lipid management included 32.8% of the participants using the ACC/AHA Guideline and 11.9% of those using the ATP III recommendation. In discriminating ASCVD, AUCs for the ASCVD risk assessment method and the CHD risk assessment method were 0.70 and 0.64, respectively (P < 0.001).

Conclusions

The distribution of 10-year ASCVD and CHD risk was different according to the risk assessment methods.