Huan Tao1 , Adrienne O’Neil 2,3, Yunseon Choi 4 , Wei Wang5 , Junfeng Wang6 , Yafeng Wang7 *, Yongqian Jia1 * and Xiong Chen8 *
1 Department of Hematology and Research Laboratory of Hematology, West China Hospital, Sichuan University, Chengdu, China, 2 The Centre for Innovation in Mental and Physical Health and Clinical Treatment, Deakin University, Geelong, VIC, Australia, 3 Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia, 4 Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea, 5 School of Mathematical Sciences, Shanghai Jiao Tong University, Shanghai, China, 6 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, 7 Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China, 8 Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Objective: The relationship between diabetes and all- and cause-specific mortality in individuals with common cancers (breast, colorectal, and prostate) remains both under-researched and poorly understood.
Methods: Cancer survivors (N = 37,993) from the National Health Interview Survey with linked data retrieved from the National Death Index served as our study participants. Cox proportional-hazards models were used to assess associations between pre- and post-diabetes and all-cause and cause-specific mortality.
Results: Over a median follow-up period of 13 years, 2,350 all-cause, 698 cancer, and 506 CVD deaths occurred. Among all cancer survivors, patients with diabetes had greater risk of: all-cause mortality [hazard ratio (HR) 1.35, 95% CI = 1.27–1.43], cancer-specific mortality (HR: 1.14, 95% CI = 1.03–1.27), CVD mortality (HR: 1.36, 95% CI = 1.18–1.55), diabetes related mortality (HR: 17.18, 95% CI = 11.51–25.64), and kidney disease mortality (HR: 2.51, 95% CI = 1.65–3.82), compared with individuals without diabetes. The risk of all-cause mortality was also higher amongst those with diabetes and specific types of cancer: breast cancer (HR: 1.28, 95% CI = 1.12–1.48), prostate cancer (HR: 1.20, 95% CI = 1.03–1.39), and colorectal cancer (HR: 1.29, 95% CI = 1.10–1.50). Diabetes increased the risk of cancer-specific mortality among colorectal cancer survivors (HR: 1.36, 95% CI = 1.04–1.78) compared to those without diabetes. Diabetes was associated with higher risk of diabetes-related mortality when compared to non-diabetic breast (HR: 9.20, 95% CI = 3.60–23.53), prostate (HR: 18.36, 95% CI = 6.01–56.11), and colorectal cancer survivors (HR: 12.18, 95% CI = 4.17–35.58). Both pre- and post-diagnosis diabetes increased the risk of all-cause mortality among all cancer survivors. Cancer survivors with diabetes had similar risk of all-cause and CVD mortality during the second 5 years of diabetes and above 10 years of diabetes as compared to non-diabetic patients.
Conclusions: Diabetes increased the risk of all-cause mortality among breast, prostate, and colorectal cancer survivors, not for pre- or post-diagnosis diabetes. Greater attention on diabetes management is warranted in cancer survivors with diabetes.
Keywords: diabetes, all-cause, cancer, cardiovascular disease, mortality, cohort study
Magda Shaheen1 *, Katrina M. Schrode1 , Marielle Tedlos 1 , Deyu Pan1 , Sonia M. Najjar 2 and Theodore C. Friedman1
1 Charles R. Drew University, Los Angeles, CA, United States, 2 Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States
Aim: Non-alcoholic fatty liver disease (NAFLD) exhibits a racial disparity. We examined the prevalence and the association between race, gender, and NAFLD among prediabetes and diabetes populations among adults in the United States.
Methods: We analyzed data for 3,190 individuals ≥18 years old from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. NAFLD was diagnosed by FibroScan ® using controlled attenuation parameter (CAP) values: S0 (none) < 238, S1 (mild) = 238-259, S2 (moderate) = 260-290, S3 (severe) > 290. Data were analyzed using Chi-square test and multinomial logistic regression, adjusting for confounding variables and considering the design and sample
Results: Of the 3,190 subjects, the prevalence of NAFLD was 82.6%, 56.4%, and 30.5% (p < 0.0001) among diabetes, prediabetes and normoglycemia populations respectively. Mexican American males with prediabetes or diabetes had the highest prevalence of severe NAFLD relative to other racial/ethnic groups (p < 0.05). In the adjusted model, among the total, prediabetes, and diabetes populations, a one unit increase in HbA1c was associated with higher odds of severe NAFLD [adjusted odds ratio (AOR) = 1.8, 95% confidence level (CI) = 1.4-2.3, p < 0.0001; AOR = 2.2, 95% CI = 1.1-4.4, p = 0.033; and AOR = 1.5, 95% CI = 1.1-1.9, p = 0.003 respectively].
Conclusion: We found that prediabetes and diabetes populations had a high prevalence and higher odds of NAFLD relative to the normoglycemic population and HbA1c is an independent predictor of NAFLD severity in prediabetes and diabetes populations. Healthcare providers should screen prediabetes and diabetes populations for early detection of NAFLD and initiate treatments including lifestyle modification to prevent the progression to non-alcoholic steatohepatitis or liver cancer.
KEYWORDS
NAFLD severity, prediabetes, diabetes, NHANES 2017-2018, race/ethnicity, gender
去疤痕 中诺医疗
在我们的生活之中难免会遇到一些伤害，而有些时候就会留下疤痕。有一些疤长久的留下了，这是非常的难看的。
慢伤前沿 中诺医疗
本文原文作者为美国加州大学戴维斯医学中心伤口护理中心主任Holly Kirkland-Kyhn博士，中文译者为河北省唐县白求恩纪念医院的张瑞红老师，作者详细介绍见文末。
家庭伤口护理指导
促进伤口愈合的方法概述
中国新闻网 中诺医疗
“十人九胃”，指的是10个人当中就有9个人有胃病。吃进去的食物，首先影响的就是胃。胃每天不停运作，一日三餐，消化吸收之后，将未消化完的食物，再传送到肠。如果饮食不慎，吃的东西难以消化，或胃本身出了问题，不能正常消化食物，都会引发胃病。为了健康和美丽，我们要学会保养好自己的胃，那有哪些养胃的食物呢？推荐13种养胃食物，常吃可以养胃护胃。
转载 中诺医疗
对于不少罹患胃肠道疾病和癌症的患者来说,首要的选择不是生或死,而是要不要成为“造口人”，医生不得不切除某些病人的一部分肠体，再将其一端透过腹部开口引出，缝合固定，排泄物将改由这里离开身体。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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