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Registration Number

0216U001540, 0113U002166 , R & D reports

Title

Investigation of prevalence diabetes mellitus type 2, gender, age, social and genetic factors of risk its development of the rural population in different regions of Ukraine

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Head

Kravchenko Victor Ivanovich,

Registration Date

18-02-2016

Organization

State institution "V.P. Komisarenko Institute of Endocrynology and Metabolism of the National Academy of Medical Science of Ukraine"

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Subject of research: prevalence of screen-detected diabetes mellitus (SDDM), isolated impaired glucose tolerance (i-IGT) or impaired fasting glucose (i-IFG) and SDDM’s gender, age, anthropometric, and biochemical risk factors among rural residents of Ukraine. Aims: to establish SDDM and pre-diabetes prevalence, its anthropometric, gender, age, social and genetic risk factors in Ukrainian rural population. Methods: a territory-based randomized selection of study participants. After obtaining written informed consent, subjects filled out questionnaires that included questions about lifestyle and family history. They underwent plasma glucose testing using a standard glucose tolerance test (GTT) protocol. They were also tested for glycosylated hemoglobin (HbA1c), iron (Fe) and zinc (Zn). Genetic typing of rs13266634 SLC30A8, anthropometric measurements and multivariate regression and ROC analysis of results were performed. Out of a total of 236 investigated persons, 194, 159 and 69 persons were selected for various types of multivariable analysis depending on the completeness of the required data. Results: Among 194 rural residents of Kiev region over the age of 44, we found 24 people with diabetic glucose levels (7.0 and / or 11.1mmol/L and above) and HbA1c (6.5% and above), thus prevalence of SDDM was 12.4%. No gender differences were found. The prevalence of GTT categories was the following: normal fasting glucose and glucose tolerance (NGT) 36.6%; i-IFG – 32.0%, i-IGT – 9.8%, and combined group – 21.6%. A distinctive feature of this study was a combination of people with glycemic indices that meet both diabetic and pre-diabetic levels in each of the 3 hyperglycemic GTT-determined categories. Most people with SDDM (75%) belonged to a combination group, 16.6% to i-IFG, and 8.3% to i-IGT. Anthropometric characteristics of individuals with i-IFG and i-IGT differed significantly: increased body mass index and neck circumference (NC) was associated with i-IFG, and increase of the waist to hip ratio increased the risk of i-IGT (all estimates regarding NGT). This study is the first to reveal that NC is a risk factor, independent of other SDDM anthropometric indices and thyroid volume. Fe levels in all hyperglycemic categories were higher than in NGT, and levels of plasma and cell Zn in i-IGT category were lower than the i-IFG (p <0.001 and p = 0.011 respectively). However the differences in alleles of rs13266634 SLC30A8 between these categories were not found. Of the 159 people who responded to the question about the starvation of their parent families, 73 persons were born before 1947. SDDM was found in 7/62 persons (11.3%), who starved during childhood vs. 6/11 (54.5%) who did not (p=0.002). Among the investigated persons suffering from famine of 1932-1933 and/or 1946 in Ukraine, there was a decrease in prevalence of SDDM a few decades after these events. Logistic regression analysis indicated a negative relationship between adult height (as a continued variable) and childhood starvation: age adjusted OR 0.86 (95% CI 0.76-0.97). 69 persons with pre-diabetes were checked and filled-out the questionnaires after 13.7 (5.2) months (mean, SD) after GTT and getting advised on diabetes prevention. Diabetic fasting blood glucose levels were found in 10 (14.5%) of them. According to Cox regression analysis increasing consumption of dairy products, as well as reducing sugar intake independently lowered the SDDM risk: respective HRs 0.075 (95% CI 0,007-0,757) and 0.098 (95% CI 0,013-0,738), p = 0.028 and 0.024. Efficacy:the study results can contribute to developing new approaches of early diagnosis and prevention of diabetes mellitus. Degree of introduction: scientific article, reports, patent, informational letter.Field of use: endocrinology

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Данилюк В.Г.
Калеватих І.В.
Ковтун В.А.
Кравченко В.І.
Красніков В.І.
Опанасенко О М.
Охріменко Н.В.
Трощинська Л.Г.
Халангот М.Д.

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2020-04-02