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  • 1
    Online Resource
    Online Resource
    Dietary Patterns and Incident Type 2 Diabetes in Chinese Men and Women
    American Diabetes Association ; 2011
    In:  Diabetes Care Vol. 34, No. 4 ( 2011-04-01), p. 880-885
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 34, No. 4 ( 2011-04-01), p. 880-885
    Abstract: To empirically derive dietary patterns and examine their association with incident type 2 diabetes. RESEARCH DESIGN AND METHODS We used data from the Singapore Chinese Health Study, including 43,176 Chinese men and women (aged 45–74 years), free of diabetes, cardiovascular disease, and cancer at baseline (1993–1998) and followed up through 2004. Two major dietary patterns were identified using principal components analysis: a vegetable, fruit, and soy-rich pattern (VFS) and a dim sum and meat-rich pattern (DSM). Pattern scores for each participant were calculated and examined with type 2 diabetes risk using Cox regression. RESULTS The associations of the two dietary patterns with diabetes risk were modified by smoking status. Neither pattern was associated with risk of diabetes in ever smokers. In never smokers, the VFS dietary pattern was inversely associated with risk of type 2 diabetes. Compared with the lowest quintile of the VFS dietary pattern score, the hazard ratios (HRs) for quintiles 2–5 were 0.91, 0.82, 0.73, and 0.75 (P = 0.0005 for trend). The DSM dietary pattern was positively associated with risk of type 2 diabetes in never smokers, with HRs for quintiles 2–5 of 1.07, 1.25, 1.18, and 1.47 (P & lt; 0.0001 for trend). CONCLUSIONS A dietary pattern with higher intake of vegetables, fruits, and soy foods was inversely associated with risk of incident type 2 diabetes, and a pattern with higher intake of dim sum, meat and processed meat, sweetened foods and beverages, and fried foods was associated with a significantly increased risk of type 2 diabetes in Chinese men and women in Singapore.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc10-2350
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2011
    detail.hit.zdb_id: 1490520-6
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  • 2
    Online Resource
    Online Resource
    Diabetes and Risk of Hip Fracture in the Singapore Chinese Health Study
    American Diabetes Association ; 2010
    In:  Diabetes Care Vol. 33, No. 8 ( 2010-08-01), p. 1766-1770
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 33, No. 8 ( 2010-08-01), p. 1766-1770
    Abstract: Asian populations are documenting rapid increases in the rates of diabetes and hip fracture, but there are no prospective data linking both diseases in Asian studies. We investigated this association among a cohort of Chinese in Singapore. RESEARCH DESIGN AND METHODS A prospective cohort of 63,257 Chinese in the Singapore Chinese Health Study, established between 1993 and 1998, was followed up for a mean duration of 12 years. Diabetes status was ascertained by baseline interviews, and incidence of hip fracture post-enrollment was identified through a nationwide hospital discharge database. RESULTS The risk of hip fracture, after adjustment for other risk factors, was almost double among people with diabetes compared with people without diabetes (relative risk 1.98, 95% CI 1.71–2.29). When stratified by BMI, the increase in risk of hip fracture among people with diabetes relative to people without diabetes was similar in all four strata. There was a very strong dose-dependent relationship between duration of diabetes and risk of hip fracture (P for trend & lt;0.0001). Compared with people without diabetes, the relative risk (95% CI) among subjects with diabetes for & lt;5 years at recruitment was 1.40 (1.08–1.82), and this risk increased to 2.66 (2.04–3.47) among individuals with diabetes for ≥15 years. CONCLUSIONS Asians with diabetes, like their Western counterparts, experience an increased risk of hip fracture. Early assessment for osteoporosis and increased fracture risk, as well as prevention of falls, should be part of the management of diabetes.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc10-0067
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2010
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  • 3
    Online Resource
    Online Resource
    BMI and Diabetes Risk in Singaporean Chinese
    American Diabetes Association ; 2009
    In:  Diabetes Care Vol. 32, No. 6 ( 2009-06-01), p. 1104-1106
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 32, No. 6 ( 2009-06-01), p. 1104-1106
    Abstract: Increased BMI is a robust risk factor for type 2 diabetes. Paradoxically, South Asians have relatively low BMIs despite their high prevalence of type 2 diabetes. We examined the association between BMI and incident type 2 diabetes because detailed prospective cohort data on this topic in Asians are scarce. RESEARCH DESIGN AND METHODS This study was a prospective analysis of 37,091 men and women aged 45–74 years in the Singapore Chinese Health Study, using Cox regression analysis. RESULTS Risk of incident type 2 diabetes significantly increased beginning with BMIs 18.5–23.0 kg/m2(relative risk 2.47 [95% CI 1.75–3.48]) and continued in a monotonic fashion across the spectrum of BMI. Results were stronger for younger than for older adults. CONCLUSIONS BMIs considered lean and normal in Singaporean Chinese are strongly associated with increased risk of incident type 2 diabetes. This association weakened with advanced age but remained significant.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc08-1674
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2009
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  • 4
    Online Resource
    Online Resource
    Genetically Determined Plasma Lipid Levels and Risk of Diabetic Retinopathy: A Mendelian Randomization Study
    American Diabetes Association ; 2017
    In:  Diabetes Vol. 66, No. 12 ( 2017-12-01), p. 3130-3141
    Details
    In: Diabetes, American Diabetes Association, Vol. 66, No. 12 ( 2017-12-01), p. 3130-3141
    Abstract: Results from observational studies examining dyslipidemia as a risk factor for diabetic retinopathy (DR) have been inconsistent. We evaluated the causal relationship between plasma lipids and DR using a Mendelian randomization approach. We pooled genome-wide association studies summary statistics from 18 studies for two DR phenotypes: any DR (N = 2,969 case and 4,096 control subjects) and severe DR (N = 1,277 case and 3,980 control subjects). Previously identified lipid-associated single nucleotide polymorphisms served as instrumental variables. Meta-analysis to combine the Mendelian randomization estimates from different cohorts was conducted. There was no statistically significant change in odds ratios of having any DR or severe DR for any of the lipid fractions in the primary analysis that used single nucleotide polymorphisms that did not have a pleiotropic effect on another lipid fraction. Similarly, there was no significant association in the Caucasian and Chinese subgroup analyses. This study did not show evidence of a causal role of the four lipid fractions on DR. However, the study had limited power to detect odds ratios less than 1.23 per SD in genetically induced increase in plasma lipid levels, thus we cannot exclude that causal relationships with more modest effect sizes exist.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db17-0398
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2017
    detail.hit.zdb_id: 1501252-9
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  • 5
    Online Resource
    Online Resource
    Multiple Nonglycemic Genomic Loci Are Newly Associated With Blood Level of Glycated Hemoglobin in East Asians
    American Diabetes Association ; 2014
    In:  Diabetes Vol. 63, No. 7 ( 2014-07-01), p. 2551-2562
    Details
    In: Diabetes, American Diabetes Association, Vol. 63, No. 7 ( 2014-07-01), p. 2551-2562
    Abstract: Glycated hemoglobin A1c (HbA1c) is used as a measure of glycemic control and also as a diagnostic criterion for diabetes. To discover novel loci harboring common variants associated with HbA1c in East Asians, we conducted a meta-analysis of 13 genome-wide association studies (GWAS; N = 21,026). We replicated our findings in three additional studies comprising 11,576 individuals of East Asian ancestry. Ten variants showed associations that reached genome-wide significance in the discovery data set, of which nine (four novel variants at TMEM79 [P value = 1.3 × 10−23], HBS1L/MYB [8.5 × 10−15] , MYO9B [9.0 × 10−12], and CYBA [1.1 × 10−8] as well as five variants at loci that had been previously identified [CDKAL1, G6PC2/ABCB11, GCK, ANK1, and FN3KI]) showed consistent evidence of association in replication data sets. These variants explained 1.76% of the variance in HbA1c. Several of these variants (TMEM79, HBS1L/MYB, CYBA, MYO9B, ANK1, and FN3K) showed no association with either blood glucose or type 2 diabetes. Among individuals with nondiabetic levels of fasting glucose ( & lt;7.0 mmol/L) but elevated HbA1c (≥6.5%), 36.1% had HbA1c & lt;6.5% after adjustment for these six variants. Our East Asian GWAS meta-analysis has identified novel variants associated with HbA1c as well as demonstrated that the effects of known variants are largely transferable across ethnic groups. Variants affecting erythrocyte parameters rather than glucose metabolism may be relevant to the use of HbA1c for diagnosing diabetes in these populations.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db13-1815
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2014
    detail.hit.zdb_id: 1501252-9
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  • 6
    Online Resource
    Online Resource
    Glycated Hemoglobin and All-Cause and Cause-Specific Mortality in Singaporean Chinese Without Diagnosed Diabetes: The Singapore Chinese Health Study
    American Diabetes Association ; 2014
    In:  Diabetes Care Vol. 37, No. 12 ( 2014-12-01), p. 3180-3187
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 37, No. 12 ( 2014-12-01), p. 3180-3187
    Abstract: Glycated hemoglobin (HbA1c) is a robust biomarker of the preceding 2 to 3 months average blood glucose level. The aim of this study was to examine the association between HbA1c and mortality in a cohort of Southeast Asians. RESEARCH DESIGN AND METHODS Analysis of 7,388 men and women, mean age 62 years, from the Singapore Chinese Health Study who provided a blood sample at the follow-up I visit (1999–2004) and reported no history of diabetes, previous adverse cardiovascular events, or cancer. A total of 888 deaths were identified through 31 December 2011 via registry linkage. Participants represented a random study sample of potential control subjects for a nested case-control genome-wide association study of type 2 diabetes in the population. Hazard ratios (HRs) for all-cause and cause-specific mortality by six categories of HbA1c were estimated with Cox regression models. RESULTS Relative to participants with an HbA1c of 5.4–5.6% (36–38 mmol/mol), participants with HbA1c ≥6.5% (≥48 mmol/mol) had an increased risk of all-cause, cardiovascular, and cancer mortality during an average of 10.1 years of follow-up; HRs (95% CIs) were 1.96 (1.56–2.46), 2.63 (1.77–3.90), and 1.51 (1.04–2.18), respectively. No level of HbA1c was associated with increased risk of respiratory mortality. Levels & lt;6.5% HbA1c were not associated with mortality during follow-up. The results did not materially change after excluding observation of first 3 years post–blood draw. CONCLUSIONS HbA1c levels consistent with undiagnosed type 2 diabetes (≥6.5%) are associated with an increased risk of all-cause and cause-specific mortality in Chinese men and women.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc14-0390
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2014
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