Creatinine-to-body weight ratio is a predictor of incident diabetes: a population-based retrospective cohort study

Purpose Creatinine to body weight (Cre/BW) ratio is considered the independent risk factor for incident type 2 diabetes mellitus (T2DM), but research on this relationship is limited. The relationship between the Cre/BW ratio and T2DM among Chinse individuals is still ambiguous. This study aimed to evaluate the correlation between the Cre/BW ratio and the risk of T2DM in the Chinese population. Methods This is a retrospective cohort study from a prospectively collected database. We included a total of 200,658 adults free of T2DM at baseline. The risk of incident T2DM according to Cre/BW ratio was estimated using multivariable Cox proportional hazards models, and a two-piece wise linear regression model was developed to find out the threshold effect. Results With a median follow-up of 3.13 ± 0.94 years, a total of 4001 (1.99%) participants developed T2DM. Overall, there was an L-shaped relation of Cre/BW ratio with the risk of incident T2DM (P for non-linearity < 0.001). When the Cre/BW ratio (× 100) was less than 0.86, the risk of T2DM decreased significantly as the Cre/BW ratio increased [0.01 (0.00, 0.10), P < 0.001]. When the Cre/BW ratio (× 100) was between 0.86 and 1.36, the reduction in the risk of developing T2DM was not as significant as before [0.22 (0.12, 0.38), P < 0.001]. In contrast, when the Cre/BW ratio (× 100) was greater than 1.36, the reduction in T2DM incidence became significantly flatter than before [0.73 (0.29,1.8), P = 0.49]. Conclusion There was an L-shaped relation of Cre/BW ratio with incidence of T2DM in general Chinese adults. A negative curvilinear association between Cre/BW ratio and incident T2DM was present, with a saturation effect predicted at 0.86 and 1.36 of Cre/BW ratio (× 100).

Ultra-processed food and incident type 2 diabetes: studying the underlying consumption patterns to unravel the health effects of this heterogeneous food category in the prospective Lifelines cohort

Background The overall consumption of ultra-processed food (UPF) has previously been associated with type 2 diabetes. However, due to the substantial heterogeneity of this food category, in terms of their nutritional composition and product type, it remains unclear whether previous results apply to all underlying consumption patterns of UPF. Methods Of 70,421 participants (35–70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. UPF was identified according to the NOVA classification. Principal component analysis (PCA) was performed to derive UPF consumption patterns. The associations of UPF and adherence to UPF consumption patterns with incidence of type 2 diabetes were studied with logistic regression analyses adjusted for age, sex, diet quality, energy intake, alcohol intake, physical activity, TV watching time, smoking status, and educational level. Results During a median follow-up of 41 months, a 10% increment in UPF consumption was associated with a 25% higher risk of developing type 2 diabetes (1128 cases; OR 1.25 [95% CI 1.16, 1.34]). PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased risk of incident type 2 diabetes; a pattern high in traditional Dutch cuisine was not associated with type 2 diabetes incidence (OR 1.05 [95% CI 0.97, 1.14]), while a pattern high in sweet snacks and pastries was inversely associated with type 2 diabetes incidence (OR 0.82 [95% CI 0.76, 0.89]). Conclusions The heterogeneity of UPF as a general food category is reflected by the discrepancy in associations between four distinct UPF consumption patterns and incident type 2 diabetes. For better public health prevention, research is encouraged to further clarify how different UPF consumption patterns are related to type 2 diabetes.

Fetuin-A and risk of diabetes-related vascular complications: a prospective study

Background Fetuin-A is a hepatokine which has the capacity to prevent vascular calcification. Moreover, it is linked to the induction of metabolic dysfunction, insulin resistance and associated with increased risk of diabetes. It has not been clarified whether fetuin-A associates with risk of vascular, specifically microvascular, complications in patients with diabetes. We aimed to investigate whether pre-diagnostic plasma fetuin-A is associated with risk of complications once diabetes develops. Methods Participants with incident type 2 diabetes and free of micro- and macrovascular disease from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (n = 587) were followed for microvascular and macrovascular complications (n = 203 and n = 60, respectively, median follow-up: 13 years). Plasma fetuin-A was measured approximately 4 years prior to diabetes diagnosis. Prospective associations between baseline fetuin-A and risk of complications were assessed with Cox regression. Results In multivariable models, fetuin-A was linearly inversely associated with incident total and microvascular complications, hazard ratio (HR, 95% CI) per standard deviation (SD) increase: 0.86 (0.74; 0.99) for total, 0.84 (0.71; 0.98) for microvascular and 0.92 (0.68; 1.24) for macrovascular complications. After additional adjustment for cardiometabolic plasma biomarkers, including triglycerides and high-density lipoprotein, the associations were slightly attenuated: 0.88 (0.75; 1.02) for total, 0.85 (0.72; 1.01) for microvascular and 0.95 (0.67; 1.34) for macrovascular complications. No interaction by sex could be observed (p > 0.10 for all endpoints). Conclusions Our data show that lower plasma fetuin-A levels measured prior to the diagnosis of diabetes may be etiologically implicated in the development of diabetes-associated microvascular disease.

The Analysis of the Factors Influencing the Severity of Bicyclist Injury in Bicyclist-Vehicle Crashes

Transportation and technological development have for centuries strongly influenced the shaping of urbanized areas. On one hand, it undoubtedly brings many benefits to their residents. However, also has a negative impact on urban areas and their surroundings. Many transportation and technological solutions lead, for example, to increased levels of pollution, noise, excessive energy use, as well as to traffic accidents in cities. So, it is important to safe urban development and sustainability in all city aspects as well as in the area of road transport safety. Due to the long-term policy of sustainable transport development, cycling is promoted, which contributes to the increase in the number of this group of users of the transport network in road traffic for short-distance transport. On the one hand, cycling has a positive effect on bicyclists’ health and environmental conditions, however, a big problem is an increase in the number of serious injuries and fatalities among bicyclists involved in road incidents with motor vehicles. This study aims to identify factors that influence the occurrence and severity of bicyclist injury in bicyclist-vehicle crashes. It has been observed that the factors increasing the risk of serious injuries and deaths of bicyclists are: vehicle driver gender and age, driving under the influence of alcohol, exceeding the speed limit by the vehicle driver, bicyclist age, cycling under the influence of alcohol, speed of the bicyclist before the incident, vehicle type (truck), incident place (road), time of the day, incident type. The obtained results can be used for activities aimed at improving the bicyclists’ safety level in road traffic in the area of analysis.

Mobile Application for Incident Reporting

In the Philippines, reporting an incident always depends on self-reporting to the nearest law enforcer's office or calling a channel using a mobile phone. 911 is the National Emergency hotline to get assistance when an emergency occurs. However, the emergency hotline operated by the Emergency Network Philippines (ENP), cannot retrieve the reporter's location details immediately. Only when the reporters describe the exact location clearly. Yet, many circumstances that the reporters do not know when they are, or sometimes they have imprecise position information. Then, the law enforcers team may not be able to come to the right place efficiently on time. The incident reporting application incorporates the three types of incidents, classified as public disturbance, ordinance violation, and crime incident. To report an incident the application will automatically get the latitude and longitude of the mobile user or an option to manually pinned the location on the google map include also the incident type, description, and photos will be sent to the nearest barangay responder officer. The barangay responder officer able to request a backup officer, the rescue emergency unit such as a hospital ambulance or firefighters, or transfer a report to the nearest police station. The system also manages web admin for responder locations and generates statistical reports including charts and graphs. The positive feedback of the participants during the evaluation stage signifies that the application was accepted as tested and verified by the evaluation results.

Adherence to the EAT-Lancet diet and risk of incident type 2 diabetes: the Danish Diet, Cancer and Health cohort

Objective: In 2019 the EAT-Lancet Commission proposed a dietary pattern, defined to be globally environmentally sustainable, but untested directly in population studies with regards to health. We investigated adherence to the EAT-Lancet diet and risk of incident type 2 diabetes in a Danish setting. Research design and methods: In total, 54,232 participants aged 50-64 years at inclusion (1993-1997) with no previous cancer or diabetes diagnoses were included. Dietary data were collected using a validated 192-item food frequency questionnaire, and scored 0 (non-adherence) or 1 (adherence) point for each of the 14 dietary components of the EAT-Lancet diet (range 0-14 points). Incident type 2 diabetes cases were identified using the Danish National Diabetes Register. Hazard ratios and 95% confidence intervals (CI) were estimated using multivariable-adjusted Cox proportional hazards models. Results: During follow-up (median 15 years), 7130 participants developed type 2 diabetes. There was a 22% (95% CI: 14%; 29%) lower risk of type 2 diabetes among those with the greatest adherence to the EAT-Lancet diet (11-14 points) compared to those with the lowest adherence (0-7 points). After further adjusting for potential mediators, the corresponding risk was 17% (95% CI: 8%; 24%) lower. Conclusion: Adherence to the EAT-Lancet diet was associated with a lower risk of developing type 2 diabetes in a middle-aged Danish population.