Incorporation of suboptimal health status as a potential risk assessment for type II diabetes mellitus: a case-control study in a Ghanaian population

Abstract

Due to a paradigm shift in lifestyles, there is growing concern that type 2 diabetes mellitus (T2DM) will reach epidemic proportions in Ghana. However, specific characteristics of the disease are under explored in this region. More challenging are those yet to be diagnosed or who complain of poor health in the absence of a diagnosed disease-suboptimal health status (SHS). We conducted a study to examine various factors that characterise SHS and T2DM. Using a cross-sectional design, we recruited 264 people as controls and 241 T2DM patients from January to June 2016. The controls were categorised into high and low SHS based on how they rated on an SHS questionnaire-25 (SHSQ-25). Anthropometric and biochemical parameters: body mass index (BMI); blood pressure (BP); fasting plasma glucose (FPG); glycated haemoglobin (HbA1c); serum lipids [(total cholesterol, triglycerides (TG), high- and low-density lipoprotein-cholesterol (HDL-c and LDL-c)] were measured. The male to female ratio for T2DM and controls were 99:142 and 98:166, respectively, whilst the mean ages were 55.89 and 51.52 years. Compared to controls, T2DM patients had higher FPG (8.96 ± 4.18 vs. 6.08 ± 1.79; < 0.0001) and HbA1c (8.23 ± 2.09 vs. 5.45 ± 1.00; < 0.0001). Primarily sedentary [adjusted odds ratio (aOR) = 2.97 (1.38-6.39); = 0.034)], systolic blood pressure (SBP) ( = 0.001) and diastolic blood pressure (DBP) ( = 0.001) significantly correlated with high SHS. After adjusting for age and gender, central adiposity [aOR = 1.74 (1.06-2.83); = 0.027)], underweight [aOR = 5.82 (1.23-27.52); = 0.018)], high SBP [aOR = 1.86 (1.14-3.05); = 0.012)], high DBP [aOR = 2.39 (1.40-4.07); = 0.001)] and high TG [aOR = 2.17 (1.09-4.33); = 0.029)] were found to be independent risk factors associated with high SHS. The management of T2DM in Ghana is suboptimal and undiagnosed risk factors remain prevalent. The SHSQ-25 can be translated and applied as a practical tool to screen at-risk individuals and hence prove useful for the purpose of predictive, preventive and personalised medicine.

Association of suboptimal health status with intestinal microbiota in Chinese youths

“…5 Although several items of SHS are similar to some diseases, SHS cannot reach the diagnosable condition of any current defined diseases. [3][4][5][6] A cross-sectional study conducted among workers in urban Beijing demonstrated that SHS was associated with cardiovascular risk factors. [3][4][5][6] A cross-sectional study conducted among workers in urban Beijing demonstrated that SHS was associated with cardiovascular risk factors.…”

Evaluation of the relationship between cognitive impairment and suboptimal health status in a northern Chinese population: a cross-sectional study

“…Suboptimal Health Status Questionnaire-25 (SHSQ-25) is the most widely used scale for measurement of SHS [7,8], which has been used in Africans, Asians and Caucasians [5]. Accumulating evidences indicated the associations between SHS and a wide range of diseases including mental disorders [9,10], psychosocial stress [11], obsessive-compulsive symptom and depression symptom [12], hypercholesterolemia [13], overweight and obesity [14], stroke [15,16], type II diabetes and cardiovascular disease [17]. All these diseases are related to the development of dementia.…”

“…The condition of SHS was measure by the questionnaire SHSQ-25 ( Table S1 in the Online Supplementary Document). The SHSQ-25 includes 25 items on five dimensions: 1) fatigue, 2) cardiovascular system, 3) digestive tract, 4) immune system and 5) mental health [12,17]. According to how often respondents experienced symptoms in the previous three months, each item was presented in a specific form on a Likert scale on a five-point scale.…”

“…The total score of SHSQ-25 of each subject was obtained by summing the scores of the 25 items. The conditions of participants were stratified into two classifications: ideal health (with summed score <35) and suboptimal health status (with summed score ≥35) [17,19]. The SHSQ-25 has good individual internal consistency with the Cronbach' s α coefficient was 0.91 [5].…”

Construct Validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian Population

“…Importantly, it encapsulates questions that comprehensively capture multiple indicators of good health, including fatigue, the cardiovascular system, the immune system, mental status and digestive tract (6,9,11). When completed, SHSQ-25 can reveal individuals who may be experiencing poor health that cannot be traced to a particular disease, referred to as Suboptimal Health Status (SHS) (6,(10)(11)(12).…”