Multilevel examination of diabetes in modernising China: what elements of urbanisation are most associated with diabetes?

Aims/hypothesis: The purpose of this study was to examine the association between urbanisation-related factors and diabetes prevalence in China. Methods: Anthropometry, fasting blood glucose (FBG) and community-level data were collected for 7,741 adults (18–90 years) across 217 communities and nine provinces in the 2009 China Health and Nutrition Survey to examine diabetes (FBG ≥7.0 mmol/l or doctor diagnosis). Sex-stratified multilevel models, clustered at the community and province levels and controlling for individual-level age and household income were used to examine the association between diabetes and: (1) a multicomponent urbanisation measure reflecting overall modernisation and (2) 12 separate components of urbanisation (e.g., population density, employment, markets, infrastructure and social factors). Results: Prevalent diabetes was higher in more-urbanised (men 12%; women 9%) vs less-urbanised (men 6%; women 5%) areas. In sex-stratified multilevel models adjusting for residential community and province, age and household income, there was a twofold higher diabetes prevalence in urban vs rural areas (men OR 2.02, 95% CI 1.47, 2.78; women, OR 1.94, 95% CI 1.35, 2.79). All urbanisation components were positively associated with diabetes, with variation across components (e.g. men, economic and income diversity, OR 1.42, 95% CI 1.20, 1.66; women, transportation infrastructure, OR 1.18, 95% CI 1.06, 1.32). Community-level variation in diabetes was comparatively greater for women (intraclass correlation [ICC] 0.03–0.05) vs men (ICC ≤0.01); province-level variation was greater for men (men 0.03–0.04; women 0.02). Conclusions/interpretation: Diabetes prevention and treatment efforts are needed particularly in urbanised areas of China. Community economic factors, modern markets, communications and transportation infrastructure might present opportunities for such efforts. Electronic supplementary material The online version of this article (doi:10.1007/s00125-012-2697-8) contains peer-reviewed but unedited supplementary material, which is available to authorised users

Burden and Rates of Treatment and Control of Cardiovascular Disease Risk Factors in Obesity: The Framingham Heart Study

OBJECTIVE— Obesity is associated with an increased risk for cardiovascular disease (CVD). We sought to determine rates of treatment and control of CVD risk factors among normal weight, overweight, and obese individuals in a community-based cohort

A Landsat time series approach to characterize bark beetle and defoliator impacts on tree mortality and surface fuels in conifer forests

Insects are important forest disturbance agents, and mapping their effects on tree mortality and surface fuels represents a critical research challenge. Although various remote sensing approaches have been developed to monitor insect impacts, most studies have focused on single insect agents or single locations and have not related observed changes to ground-based measurements. This study presents a remote sensing framework to (1) characterize spectral trajectories associated with insect activity of varying duration and severity and (2) relate those trajectories to ground-based measurements of tree mortality and surface fuels in the Cascade Range, Oregon, USA. We leverage a Landsat time series change detection algorithm (LandTrendr), annual forest health aerial detection surveys (ADS), and field measurements to investigate two study landscapes broadly applicable to conifer forests and dominant insect agents of western North America. We distributed 38 plots across multiple forest types (ranging from mesic mixed-conifer to xeric lodgepole pine) and insect agents (defoliator [western spruce budworm] and bark beetle [mountain pine beetle]). Insect effects were evident in the Landsat time series as combinations of both short- and long-duration changes in the Normalized Burn Ratio spectral index. Western spruce budworm trajectories appeared to show a consistent temporal evolution of long-duration spectral decline (loss of vegetation) followed by recovery, whereas mountain pine beetle plots exhibited both short- and long-duration spectral declines and variable recovery rates. Although temporally variable, insect-affected stands generally conformed to four spectral trajectories: short-duration decline then recovery, short- then long-duration decline, long-duration decline, long-duration decline then recovery. When comparing remote sensing data with field measurements of insect impacts, we found that spectral changes were related to cover-based estimates (tree basal area mortality R(adj)(2);= 0.40, F(1.34) = 24.76, P<0.0001] and down coarse woody detritus [R(adj)(2) = 0.29, F(1.32) = 14.72. P = 0.0006]). In contrast, ADS changes were related to count-based estimates (e.g., ADS mortality from mountain pine beetle positively correlated with ground-based counts [R(adj)(2) = 037, F(1.22) = 14.71, P= 0.0009]). Fine woody detritus and forest floor depth were not well correlated with Landsat- or aerial survey-based change metrics. By characterizing several distinct temporal manifestations of insect activity in conifer forests, this study demonstrates the utility of insect mapping methods that capture a wide range of spectral trajectories. This study also confirms the key role that satellite imagery can play in understanding the interactions among insects, fuels, and wildfire. (C) 2011 Elsevier Inc. All rights reserved.Keywords: Mountain pine beetle, Spectral trajectory, Western spruce budworm, Landsat time series, Defoliator, Pacific Northwest, Bark beetle, Fuel, Change detection, Insect disturbance, Fir

Haplotype Structure of the ENPP1 Gene and Nominal Association of the K121Q Missense Single Nucleotide Polymorphism With Glycemic Traits in the Framingham Heart Study

OBJECTIVE—A recent meta-analysis demonstrated a nominal association of the ectonucleotide pyrophosphatase phosphodiesterase 1 (ENPP1) K→Q missense single nucleotide polymorphism (SNP) at position 121 with type 2 diabetes. We set out to confirm the association of ENPP1 K121Q with hyperglycemia, expand this association to insulin resistance traits, and determine whether the association stems from K121Q or another variant in linkage disequilibrium with it

Effect of Aging on A1C Levels in Individuals Without Diabetes: Evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001–2004

OBJECTIVE—Although glycemic levels are known to rise with normal aging, the nondiabetic A1C range is not age specific. We examined whether A1C was associated with age in nondiabetic subjects and in subjects with normal glucose tolerance (NGT) in two population-based cohorts

Role of Adiposity and Lifestyle in the Relationship Between Family History of Diabetes and 20-Year Incidence of Type 2 Diabetes in U.S. Women

OBJECTIVE - To evaluate to what extent the association between family history of diabetes and risk of type 2 diabetes can be explained by excess adiposity and lifestyle risk factors. RESEARCH DESIGN AND METHODS - We analyzed data from 73,227 women who participated in the Nurses' Health Study cohort. A family history of diabetes was defined as having at least one first-degree family member with diabetes. Lifestyle factors, weight, and height were assessed by using validated questionnaires, and BMI was calculated. The relative risk of type 2 diabetes was estimated using Cox proportional hazards analysis. RESULTS - We documented 5,101 cases of type 2 diabetes during 20 years of follow-up. The age-adjusted relative risk of type 2 diabetes in participants with a family history was 2.27 (95% CI 2.14-2.40) compared with the risk in those without a family history of diabetes. Participants with a family history of diabetes had a higher BMI and were more likely to have a parental history of obesity. BMI explained 21.1% (19.4-22.9) of the association between family history of diabetes and risk of type 2 diabetes. Intakes of red meat, alcohol, and sugar-sweetened beverages explained 1.1% (0.8-1.3), 4.8% (4.3-5.3), and 2.8% (2.4-3.2) of this association, respectively. CONCLUSIONS - These results suggest that excess adiposity and, to a lesser extent, specific dietary habits can explain a substantial part of the association between having a family history of diabetes and risk of type 2 diabetes. © 2010 by the American Diabetes Association

Personalized Genetic Risk Counseling to Motivate Diabetes Prevention: A randomized trial

OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top and bottom score quartiles received individual genetic counseling before being enrolled with untested control participants in a 12-week, validated, diabetes prevention program. Middle-risk quartile participants were not studied further. We examined the effect of this genetic counseling intervention on patient self-reported attitudes, program attendance, and weight loss, separately comparing higher-risk and lower-risk result recipients with control participants. RESULTS The 108 participants enrolled in the diabetes prevention program included 42 participants at higher diabetes genetic risk, 32 at lower diabetes genetic risk, and 34 untested control subjects. Mean age was 57.9 ± 10.6 years, 61% were men, and average BMI was 34.8 kg/m2, with no differences among randomization groups. Participants attended 6.8 ± 4.3 group sessions and lost 8.5 ± 10.1 pounds, with 33 of 108 (30.6%) losing ≥5% body weight. There were few statistically significant differences in self-reported motivation, program attendance, or mean weight loss when higher-risk recipients and lower-risk recipients were compared with control subjects (P > 0.05 for all but one comparison). CONCLUSIONS Diabetes genetic risk counseling with currently available variants does not significantly alter self-reported motivation or prevention program adherence for overweight individuals at risk for diabetes

A scanning transmission x-ray microscope for materials science spectromicroscopy at the advanced light source

Design and performance of a scanning transmission x-ray microscope (STXM) at the Advanced Light Source is described. This instrument makes use of a high brightness undulator beamline and extends the STXM technique to new areas of research. After 2.5 years of development it is now an operational tool for research in polymer science, environmental chemistry, and magnetic materials. © 1998 American Institute of Physics.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71051/2/RSINAK-69-8-2964-1.pd