Lipid ratios and appropriate cut off values for prediction of diabetes: a cohort of Iranian men and women

<p>Abstract</p> <p>Background</p> <p>Dyslipidemia is a risk factor for incident type 2 diabetes; however, no study has specifically assessed the lipid ratios (i.e. total cholesterol (TC)/high density lipoprotein cholesterol (HDL-C) and triglyceride (TG)/HDL-C) as predictors of diabetes. We aimed to compare the independent association between the different lipid measures with incident diabetes over a median follow up of 6.4 years in Iranian men and women.</p> <p>Method</p> <p>The study population consisted of 5201 non diabetic (men = 2173, women = 3028) subjects, aged ≥20 years. The risk factor adjusted odds ratios (ORs) for diabetes were calculated for every 1 standard deviation (SD) change in TC, log-transformed TG, HDL-C, non-HDL-C, TC/HDL-C and log-transformed TG/HDL-C using multivariate logistic regression analysis. Receiver operator characteristic (ROC) curve analysis was used to define the points of the maximum sum of sensitivity and specificity (MAXss) of each lipid measure as a predictor of diabetes.</p> <p>Result</p> <p>We found 366 (146 men and 220 women) new diabetes cases during follow-up. The risk-factor-adjusted ORs for a 1 SD increase in TG, TC/HDL-C and TG/HDL-C were 1.23, 1.27 and 1.25 in men; the corresponding risks in females were 1.36, 1.14, 1.39 respectively (all p < 0.05, except TC/HDL-C in females which was marginally significant, p = 0.07). A 1 SD increase of HDL-C only in women decreased the risk of diabetes by 25% [0.75(0.64-0.89)]. In both genders, there was no difference in the discriminatory power of different lipid measures to predict incident diabetes in the risk factor adjusted models (ROC ≈ 82%). TG cutoff values of 1.98 and 1.66 mmol/l; TG/HDL-C cutoff values of 4.7 and 3.7, in men and women, respectively, TC/HDL-C cutoff value of 5.3 in both genders and HDL-C cutoff value of 1.18 mmol/l in women yielded the MAXss for defining the incidence of diabetes.</p> <p>Conclusion</p> <p>TC/HDL-C and TG/HDL-C showed similar performance for diabetes prediction in men population however; among women TG/HDL-C highlighted higher risk than did TC/HDL-C, although there was no difference in discriminatory power. Importantly, HDL-C had a protective effect for incident diabetes only among women.</p

Explanation of the spiritual health care at different levels of prevention

ارتقای سلامت معنوی به دو طریق قابل اجرا است: اول افزایش ایمان و معنویت جامعه؛ دوم این‌که از سلامت معنوی برای ارتقای ابعاد دیگر سلامت، یعنی سلامت جسمی، روانی و اجتماعی استفاده شود. از آنجایی که اعتقادات مذهبی انسان بر سبک زندگی و سلامت وی تأثیر می‌گذارند، صاحبان حرف پزشکی که برای ارتقای سلامت انسان‌ها تلاش می‌کنند باید با موضوع سلامت معنوی آشنا باشند. آن‌ها می‌بایست با نحوه ارزیابی سلامت معنوی، ارائه مراقبت معنوی به بیماران و یا ارجاع بیمار به روحانیون مذهبی برای مراقبت معنوی آشنا باشند. در این نوشتار، ما مراقبت سلامت معنوی در سطوح مختلف پیشگیری تبیین نموده و اهمیت به کارگیری سلامت معنوی برای ارتقای سایر ابعاد سلامت و روش‌های سنجش آن را به اختصار شرح می‌دهیم. در نتیجه، به منظور حفظ و ارتقای سلامت و خوب زیستی بیماران، صاحبان حرف پزشکی باید مراقبت‌های خود را به همه ابعاد یک انسان، یعنی جسم، روان و روح وی گسترش دهند.The spiritual health can be implemented in two ways: to increase the faith and spirituality of people or to promote other aspects of the health, including physical, mental and social health. Regarding to effect of the religious behaviors on promotion of the human health and lifestyle, health care professionals who strive to promote health must be familiar with domain of spiritual health. They should know how to evaluate spirituality and in what way they could take part for effective Islamic spiritual care, in conjunction with Muslim scholars. In this paper, we explain spiritual health care in the different levels of prevention and then, describe the importance of applying spiritual health to promote other aspects of the health and the manners of evaluation of spiritual health. In conclusion, at stake in the health and well-being of patients, health care professionals must develop taking care to the whole person, i.e. body, mind and spirit. Please cite this article as: Azizi, F. (2017). Explanation of the spiritual health care at different levels of prevention.&nbsp;Med History J. 8(29): 165-183

سلامت معنوی و مراقبت‌های سلامت و پزشکی

Spiritual Health has been known as one of the four dimensions of health and World Health Organization has asked member states to try for Provide, maintain and improve this dimension of health. The studies show that unfortunately medical professionals don’t become acquainted to concepts and indicators of spiritual health during their education in medical and paramedical universities. So they avoid to attention to spiritual health in providing health services while holistic medicine emphasizes on attention to all dimensions of health such as spiritual, physical, mental and social by medical professionals. Therefore the present study reviews medical care in field of spiritual health and its approaches.سلامت معنوی به عنوان یکی از ابعاد چهارگانه سلامت شناخته شده است و سازمان جهانی بهداشت از کشورهای عضو خواسته است که برای تأمین، حفظ و ارتقای این بعد از سلامت تلاش نمایند. مطالعات نشان‌دهنده آن است که متأسفانه صاحبان حرف پزشکی در طی دوران تحصیل در دانشکده‌های پزشکی و پیراپزشکی با مفاهیم و شاخص‌های سلامت معنوی آشنا نمی‌شوند. از این رو در ارائه خدمات بهداشتی درمانی، از رسیدگی به بعد سلامت معنوی احتراز می‌نمایند. در حالی که دیدگاه پزشکی کل‌نگر بر پرداختن صاحبان مشاغل پزشکی به همه ابعاد سلامت شامل سلامت معنوی، جسمی، روانی و اجتماعی تأکید دارد. از این رو مطالعه حاضر به مروری بر مراقبت‌های پزشکی در حیطه سلامت معنوی و راهکارهای آن می‌پردازد