BackgroundAntipsychotics have serious metabolic side effects on blood glucose. However, the comparative influence of these drugs on blood glucose levels has not been comprehensively evaluated. We conducted a network meta-analysis to create a hierarchy of the side effects of 12 antipsychotic drugs on changes in blood glucose levels.MethodsA systematic search of the PubMed, EMBASE and Cochrane databases (last search June 2016) was conducted to identify studies that reported randomized controlled trials (RCTs) comparing changes in blood glucose levels between patients receiving one of 12 antipsychotic drugs or a placebo for the treatment of schizophrenia or related disorders. The studies we searched were limited to those published in English. Two reviewers independently extracted data. The primary outcome of interest was changes in fasting glucose levels.ResultsWe included 47 studies with 114 relevant arms. Of the antipsychotic drugs, only olanzapine was associated with significantly increased glucose levels compared to a placebo (mean difference (MD) = 3.95, 95% confidence interval (CI) = 0.14 to 7.76). Moreover, olanzapine was associated with a significantly greater change in the glucose levels than ziprasidone (MD = 5.51, 95% CI = 1.62 to 9.39), lurasidone (MD = 5.58, 95% CI = 0.53 to 10.64) or risperidone (MD = 3.05, 95% CI = 0.87 to 5.22). Ziprasidone and lurasidone were associated with minimal glucose changes compared to the other antipsychotics.ConclusionsOlanzapine was associated with a significantly greater change in blood glucose levels than ziprasidone, lurasidone, risperidone or placebo treatment. The application of a hierarchy of glucose metabolism-related side effects may help clinicians tailor the choice of antipsychotic drug to meet the needs of individual patients.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1539-0) contains supplementary material, which is available to authorized users.
Many factors affect menopausal age, and early or late onset of menopause may be associated with many chronic health problems. However, limited data are available regarding this phenomenon in the Northeast China population. For this study, 2011 elderly women were selected as a sample from participants in a cross-sectional survey performed using stratified, clustered multistage, and random sampling methods. Early menopause was more prevalent in subjects born from 1943 to 1947 (OR = 1.708, 95% CI = 1.205, 2.420) and 1933 to 1937 (OR = 2.445, 95% CI: 1.525, 3.921) and in physical laborers (OR = 1.413, 95% CI = 1.021, 1.957). Women with less than nine years of education (OR = 0.515, 95% CI: 0.327, 0.812) and who were current smokers (OR = 0.577, 95% CI: 0.347, 0.959) were less likely to have late menopause. BMIs between 25 and 30 (OR = 1.565, 95% CI: 1.152, 2.125) and greater than 30 (OR = 2.440, 95% CI: 1.482, 4.016) were associated with later menopausal age. Late menopause was positively associated with diabetes (OR = 1.611, 95% CI: 1.142, 2.274) but protective against chronic gastroenteritis/peptic ulcers (OR = 0.533, 95% CI: 0.333, 0.855). Results showed that (1) Being born in an earlier year, having a lower education, and engaging in physical labor were associated with an earlier menopausal age, while a higher BMI was associated with a later menopausal age; and that (2) menopausal age was associated with diabetes and gastroenteritis in elderly women living in Northeast China.
ObjectiveThe goal of this study is to investigate the associations of apolipoprotein A5 (APOA5) polymorphisms with coronary artery disease (CAD) in a Chinese population.MethodThis case–control study included 710 subjects (355 patients with CAD and 355 controls) who were recruited from a cross-sectional study. Three single nucleotide polymorphisms (SNPs) rs662799 (−1131T>C), rs651821 (−3A>G) and rs2075291 (G185C) in APOA5 were selected and genotyped using the matrix-assisted laser desorption ioniasation time of flight mass spectrometry technology. The χ2 test and haplotype analysis were performed to analyse the associations between APOA5 SNPs and CAD using the SPSS V.22.0 software package and the online SNPStats program.Results APOA5 SNPs rs662799 and rs651821 exhibited significant differences in genotype and allele distributions between patients with CAD and control subjects. The SNP rs662799 was significantly correlated with an increased risk of CAD when a dominant model was considered. The SNP rs651821 was significantly correlated with an increased risk of CAD when a codominant model was considered. Moreover, the variant C alleles of rs662799 and the variant G alleles of the rs651821 polymorphism were significantly correlated with increased plasma triglyceride (TG) levels in the CAD group (all p<0.05). Additionally, a mediating effect of TG on the associations between the APOA5 rs662799 and rs651821 polymorphisms and CAD was observed.ConclusionBased on these data, variants of the APOA5 gene are associated with CAD susceptibility and may modulate plasma TG levels among a Chinese population.
Menopausal status is associated with weight gain, increased central fat mass, abnormal lipid metabolism, insulin resistance and susceptibility to metabolic syndrome (MetS). Leptin is synthesised and secreted by adipocytes. Serum leptin levels are highly correlated with fat mass. We determined the association between MetS and serum leptin levels in 153 postmenopausal women. The difference in serum leptin level between MetS and non-MetS groups showed a statistical significance after adjusting for body mass index (BMI; 19.9 ± 9.5 vs 12.1 ± 5.9 ng/ml, p = 0.013). The indicator of abdominal obesity, waist-to-hip ratio (WHR) and visceral fat area (VFA), had a positive correlation with serum leptin level in non-obese subjects after adjusting for BMI (p = 0.017, p < 0.001, respectively). Of the components of MetS, abdominal obesity and the number of MetS components had a positive correlation with serum leptin level (p < 0.05, p < 0.001, respectively).
Previous studies suggested that malnutrition during early life may play an essential role in later outcomes and disease risk in adulthood. We aimed to investigate the risks of hyperglycemia and diabetes 50 years after early-life famine exposure in a Northeastern Chinese population. We used the data from 5690 adults born between 1956 and 1965 in selected communities from a 2012 cross-sectional study. The early-childhood exposure cohort showed an increased risk of hyperglycemia compared with the unexposed cohort in the female population (odds ratio (OR) 1.46; 95% confidence interval (CI) 1.04, 2.06). The increased risk of diabetes in the early-childhood and fetal exposure cohorts was 37.0% (95% CI 1.05–1.79) and 50% (95% CI 1.15–1.96), respectively. For women, the risk of diabetes was more pronounced in the fetal-exposed cohort (OR 1.82; 95% CI 1.26–2.63) than in the early-childhood cohort (OR 1.57; 95% CI 1.08–2.26). Early-life exposure to famine increased the risk of diabetes. Furthermore, early-childhood exposure to famine might increase the risk of hyperglycemia in women. A policy for preventing early life malnutrition should be drafted by the government to prevent hyperglycemia and diabetes in adulthood.
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