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Sex Difference in the Effect of Body Mass Index and Stress on High-Risk Diabetes Mellitus in Korean Adults

한국 성인의 고 위험 당뇨에 대한 스트레스와 체질량 지수의 성별 차이

  • Lee, Hea Shoon (Department of Nursing, College of Life Science and Nano Technology, Hannam University)
  • Received : 2019.03.31
  • Accepted : 2019.08.14
  • Published : 2019.08.31

Abstract

Purpose: This study aimed to investigate sex differences in the effect of body mass index (BMI) and stress on high-risk diabetes mellitus (DM). Methods: Secondary analysis of data from 4,271 male and female adults participating in the Sixth Korea National Health and Nutrition Examination Survey 2015 was performed. The participants were evaluated using questionnaires and blood tests. Data were analyzed using descriptive statistics, t-test, ${\chi}^2-test$, and multiple logistic regression analysis (SPSS 24.0). Results: To identify sexspecific effects, interaction variables were included. Hemoglobin A1c (HbA1c) level was higher in men than in women, and the risk of DM decreased 0.31 times in women compared to that in men. As age increased, the odds of risk DM increased 1.03. The risk of DM increased 1.99 times in overweight individuals and 2.79 times for obese individuals compared to that in individuals with normal weight. Stress levels were higher in women than in men, but stress is not an influential factor in high-risk DM. In age-sex interaction, the odds of risk DM increased 1.02 in women compared to that in men as age increased. Conclusion: HbA1c level was affected by age-sex interaction, and age and sex should be considered in the application of HbA1c in the diagnosis of DM.

Keywords

References

  1. International Diabetes Federation. Diabetes Atlas (6th ed). Belgium: International Diabetes Federation, 2011. p.34.
  2. Centers for Disease Control and Prevention. National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention , 2011.
  3. Brown AF, Mangione CM, Saliba D, Sarkisian CA. Guidelines for improving the care of the older person with diabetes mellitus. Journal of the American Geriatrics Society. 2003: 51(5): S265-S280. http://dx.doi.org/10.1046/j.1532-5415.51.5s.1.x
  4. Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: Dynamic modeling of incidence, mortality, and prediabetes prevalence. Population Health Metrics. 2010; 8(29):1-2. http://dx.doi.org/10.1186/1478-7954-8-29.
  5. World Health Organization. Obesity and Overweight [Internet]. Geneva: World Health Organization 2017, [cited 2019 March 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  6. Hayashi T, Boyko EJ, Leonetti DL, McNeely MJ, Newell-Morris L, Kahn SE, et al. Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans. Annals of Internal Medicine. 2004; 140(12):992-1000. http://dx.doi.org/ 10.7326/0003-4819-140-12-200406150-00008
  7. Assmann G, Nofer JR, Schulte H. Cardiovascular risk assessment in the metabolic syndrome: view from PROCAM. Endocrinology and Metabolism Clinics of North America. 2004; 33(2):372-392. http://dx.doi.org/10.1016/j.ecl.2004.03.017
  8. Berry E, Lockhart S, Davies M, Lindsay JR, Dempster M. Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies. Postgraduate Medical Journal. 2015; 91(2):278-283. http://dx.doi.org/10.1136/postgradmedj-2014-133017
  9. Bener A, Al-Laftah F, Al-Hamaq AOAA, Daghash M, Abdullatef WK. A study of diabetes complications in an endogamous population: An emerging public health burden. Diabetology & Metabolic Syndrome.2014; 8(2):108-114. http://dx.doi.org/10.1016/j.dsx.2014.04.005
  10. Kogler L, Gur RC, Derntl B. Sex differences in cognitive regulation of psychosocial achievement stress: brain and behavior. Human Brain Mapping. 2015;6(3):1028-1042. http://dx.doi.org/10.1002/hbm.22683
  11. Lloyd CE, Dyer PH, Lancashire RJ, Harris T, Daniels JE, Barnett AH. Association between stress and glycemic control in adults with type 1 (insulin-dependent) diabetes. Diabetes Care, 1999; 22(8):1278-1283.http://dx.doi.org/10.2337/diacare.22.8.1278
  12. Raspopow K, Abizaid A, Matheson K, Anisman H. Anticipation of a psychosocial stressor differentially influences ghrelin, cortisol and food intake among emotional and non-emotional eaters. Appetite. 2014; 74(1):35-43. http://dx.doi.org/10.1016/j.appet.2013.11.018
  13. Hermans N, Kulzer B, Krichbaum M, Kubiak T, Haak T. How to screen for depression and emotional problems in patients with diabetes: Comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment. Diabetic medicine. 2005; 22(3):293-300. http://dx.doi.org/10.1007/s00125-005-0094-2
  14. Nakagami T, Tominaga M, Nishimura R, Daimon M, Oizumi T, Yoshiike N. The combined use of fasting plasma glucose and glycated hemoglobin A1c in a stepwise fashion to detect undiagnosed diabetes mellitus. The Tohoku Journal of Experimental Medicine. 2007; 213(1):25-32. http://dx.doi.org/10.1620/tjem.213.25.
  15. Ma Q, Liu H, Xiang G, Shan W, Xing A. Association between glycated hemoglobin A1c levels with age and gender in Chinese adults with no prior diagnosis of diabetes mellitus. Biomedical Reports. 2016; 4(1):737-740. http://dx.doi.org/10.3892/br.2016.643
  16. Colagiuri S. Glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus practical implications. Diabetes Research and Clinical Practice. 2011; 93(1):312-313. http://dx.doi.org/10.1016/j.diabres.2011.06.025
  17. Kang HT, Shim JY, Lee HR, Park BJ, Linton JA, Lee YJ. Trends in prevalence of overweight and obesity in Korean adults, 1998-2009: the Korean national health and nutrition examination survey. Japan Epidemiological Association.2014; 24(2): 109-116. http://dx.doi.org/10.2188/jea.JE20130017
  18. Whittemore R, D'Eramo Melkus G, Grey M. Metabolic control, self-management and psychosocial adjustment in women with type 2 diabetes. Journal of Clinical Nursing. 2005;14(2):195-203. http://dx.doi.org/10.1111/j.1365-2702.2004.00937.x
  19. Yang YC, Lu FH, Wu JS, Chang CJ. Age and sex effects on HbA1c: A study in a healthy Chinese population. Diabetes Care. 1997; 20(5):988-991. http://dx.doi.org/10.2337/diacare.20.6.988
  20. Sim KW, Lee SH, Lee HS. The relationship body mass index and morbidity in Korea. Journal of Korean Society for the Study of Obesity. 2001;10(2):147-155.
  21. World Health Organization Western Pacific Region. The Asia-pacific perspective: Redefining obesity and its Treatment. Australia: WHO Western Pacific Region, 2000 Feb. Report No.: 0-9577082-1-12000
  22. Karar T, Alhammad RI, Fattah MA, Alanazi A, Qureshi S. Relation between glycosylated hemoglobin and lipid and thyroid hormone among patients with type 2 diabetes mellitus at King Abdulaziz Medical City, Riyadh. Journal of Natural Science, Biology, and Medicine. 2015; 6(Suppl 1):S75-S79. http://dx.doi.org/10.4103/0976-9668.166091.
  23. Rosediani M, Azidah AK, Mafauzy M. Correlation between fasting plasma glucose, post prandial glucose and glycated hemoglobin and fructosamine. The Medical Journal of Malaysia. 2006;61(3):67-71.
  24. Inoue M, Inoue K, Akimoto K. Effects of age and sex in the diagnosis of type 2 diabetes using glycated hemoglobin in Japan: the yuport medical check-up center study. PLoS One. 2002; 7(2): e40375. http://dx.doi.org/10.1371/journal.pone.0040375
  25. Jung SM, Kim EK, Lee HH, Jung KM, Park JW, Ko J, et al. The relationship between smoking and hemoglobin A1c in adults without diabetes mellitus according to body mass index. Korean Journal of Family Practice. 2016; 6(4):339-345. http://dx.doi.org/10.21215/kjfp.2016.6.4.339
  26. Nah EH, Cho HI. Relationship between hemoglobin A1c levels and metabolic syndrome using data collected during a Medical check-ups program. Laboratory Medicine Online. 2011;1(1):3-9. http://dx.doi.org/10.3343/lmo.2011.1.1.2
  27. Gilliland SS, Carter JS, Skipper B, Acton KJ. HbA(1c) levels among american indian/alaska native adults. Diabetes Care. 2002; 25(3):2178-2183. http://dx.doi.org/10.2337/diacare.25.12.2178
  28. Bener A, Ozturk M, Yildirim E. Association between depression, anxiety and stress symptoms and glycemic control in diabetes mellitus patients. International Journal of Clinical Endocrinology. 2017; 1(1):1-7.
  29. Pani LN, Korenda L, Meigs JB, Driver C, Chamany S, Fox CS. 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. Diabetes Care. 2008; 31(4):1991-1996. http://dx.doi.org/10.2337/dc08-0577.