Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Eberhardt MS [original query] |
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Prevalence of diabetes by BMI: China Nutrition and Health Surveillance (2015-2017) and U.S. National Health and Nutrition Examination Survey (2015-2018)
Yu D , Martin CB , Fryar CD , Hales CM , Eberhardt MS , Carroll MD , Zhao L , Ogden CL . AJPM Focus 2024 3 (3) 100215 INTRODUCTION: The risk of diabetes begins at a lower BMI among Asian adults. This study compares the prevalence of diabetes between the U.S. and China by BMI. METHODS: Data from the 2015-2017 China Nutrition and Health Surveillance (n=176,223) and the 2015-2018 U.S. National Health and Nutrition Examination Survey (n=4,464) were used. Diagnosed diabetes was self-reported. Undiagnosed diabetes was no report of diagnosed diabetes and fasting plasma glucose ≥126 mg/dL or HbA1c ≥6.5%. Predicted age-adjusted prevalence estimates by BMI were produced using sex- and country-specific logistic regression models. RESULTS: In China, the age-adjusted prevalence of total diabetes was 7.8% (95% CI=7.4%, 8.3%), lower than the 14.6% (95% CI=13.1%, 16.3%) in the U.S. The prevalence of diagnosed diabetes was also lower in China than in the U.S. There were no statistically significant differences in the prevalence of undiagnosed diabetes between China and the U.S. The distribution of BMI in China was lower than in the U.S., and the predicted prevalence of total diabetes was similar between China and the U.S. when comparing adults with the same BMI. The predicted prevalence of undiagnosed diabetes was higher in China than in the U.S. for both men and women, and this disparity increased with BMI. When comparing adults at the same BMI, there was little difference in the prevalence of total diabetes, but diagnosed diabetes was lower in China than in the U.S., and undiagnosed was higher. CONCLUSIONS: Although differences in BMI appear to explain nearly all of the differences in total diabetes prevalence in the 2 countries, not all factors that are associated with diabetes risk have been investigated. |
Anemia prevalence and trends in adults aged 65 and older: U.S. National Health and Nutrition Examination Survey: 2001-2004 to 2013-2016
Seitz AE , Eberhardt MS , Lukacs SL . J Am Geriatr Soc 2018 66 (12) 2431-2432 To the Editor: The prevalence of anemia is known to increase with age and is associated with negative health outcomes, including greater risk of hospitalizations and greater mortality.1 Anemia in older adults can be due to nutrient deficiencies, chronic kidney disease, chronic inflammation, or inflammatory disease or can be unexplained.2 Because of the potential health consequences and potentially changing prevalence of underlying causes, it is important to have updated national anemia estimates and trends over time for this population. |
Depressive states among adults with diabetes: Findings from the National Health and Nutrition Examination Survey, 2007-2012
Albertorio-Diaz JR , Eberhardt MS , Oquendo M , Mesa-Frias M , He Y , Jonas B , Kang K . Diabetes Res Clin Pract 2017 127 80-88 AIMS: To determine (1) the prevalence of SubD states among adults with diabetes, and (2) whether evidence exists of an independent association between diabetes status and SubD, controlling for selected confounders. METHODS: Data from the 2007-2012 National Health and Nutrition Examination Surveys were combined to estimates of depressive states by diabetes status among the noninstitutionalized U.S. adult population, and to assess the association of diabetes status and depressive states using a polytomous logistic regression model. RESULTS: An estimated 17%, or 3.7 million, of U.S. adults with diabetes (diagnosed and undiagnosed) met criteria for either mD or ssD. The majority of SubD cases with diabetes were found to be ssD (10.1%) compared with mD (6.9%). After controlling for the effects of age, sex, race and ethnicity, education, body mass index, and poverty as covariates, an independent association persists between diagnosed diabetes and each SubD grouping (ssD: OR=1.82, CIs 1.33, 2.47; mD: OR=1.95, CIs 1.39, 2.74) compared with respondents having no diabetes. No association was found between depression and undiagnosed diabetes or prediabetes compared with those having no diabetes. CONCLUSION: Milder forms of depression such as ssD and mD are more extant than major depressive episodes among adults with diabetes. The odds that an adult with diagnosed diabetes meets the criteria for ssD or mD are higher by 80% and 95%, respectively, after controlling for age, sex, race and ethnicity, education, body mass index, and poverty factors when compared against adults with no diabetes. |
Trends in prevalence of chronic kidney disease in the United States
Murphy D , McCulloch CE , Lin F , Banerjee T , Bragg-Gresham JL , Eberhardt MS , Morgenstern H , Pavkov ME , Saran R , Powe NR , Hsu CY . Ann Intern Med 2016 165 (7) 473-481 Background: Trends in the prevalence of chronic kidney disease (CKD) are important for health care policy and planning. Objective: To update trends in CKD prevalence. Design: Repeated cross-sectional study. Setting: NHANES (National Health and Nutrition Examination Survey) for 1988 to 1994 and every 2 years from 1999 to 2012. Participants: Adults aged 20 years or older. Measurements: Chronic kidney disease (stages 3 and 4) was defined as an estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1.73 m2, estimated with the Chronic Kidney Disease Epidemiology Collaboration equation from calibrated serum creatinine measurements. An expanded definition of CKD also included persons with an eGFR of at least 60 mL/min/1.73 m2 and a 1-time urine albumin-creatinine ratio of at least 30 mg/g. Results: The unadjusted prevalence of stage 3 and 4 CKD increased from the late 1990s to the early 2000s. Since 2003 to 2004, however, the overall prevalence has largely stabilized (for example, 6.9% prevalence in 2003 to 2004 and in 2011 to 2012). There was little difference in adjusted prevalence of stage 3 and 4 CKD overall in 2003 to 2004 versus 2011 to 2012 after age, sex, race/ethnicity, and diabetes mellitus status were controlled for (P = 0.26). Lack of increase in CKD prevalence since the early 2000s was observed in most subgroups and with an expanded definition of CKD that included persons with higher eGFRs and albuminuria. Limitation: Serum creatinine and albuminuria were measured only once in each person. Conclusion: In a reversal of prior trends, there has been no appreciable increase in the prevalence of stage 3 and 4 CKD in the U.S. population overall during the most recent decade. Primary Funding Source: American Society of Nephrology Foundation for Kidney Research Student Scholar Grant Program, Centers for Disease Control and Prevention, and National Institutes of Health. |
Preventive aspirin and other antiplatelet medication use among U.S. adults aged ≥40 years: data from the National Health and Nutrition Examination Survey, 2011-2012
Gu Q , Dillon CF , Eberhardt MS , Wright JD , Burt VL . Public Health Rep 2015 130 (6) 643-54 OBJECTIVE: We estimated the prevalence of preventive aspirin and/or other antiplatelet medication use and the dosage of aspirin use in the U.S. adult population. METHODS: We conducted cross-sectional analyses of a representative sample (n=3,599) of U.S. adults aged ≥40 years from the National Health and Nutrition Examination Survey, 2011-2012. RESULTS: In 2011-2012, one-third of U.S. adults aged ≥40 years reported taking preventive aspirin and/or other antiplatelet medications, 97% of whom indicated preventive aspirin use. Preventive aspirin use increased with age (from 11% of those aged 40-49 years to 54% of those ≥80 years of age, p<0.001). Non-Hispanic white (35%) and black (30%) adults were more likely to take preventive aspirin than non-Hispanic Asian (20%, p<0.001) and Hispanic (22%, p=0.013) adults. Adults with, compared with those without health insurance, and adults with ≥2 doctor visits in the past year, diagnosed diabetes, hypertension, or high cholesterol were twice as likely to take preventive aspirin. Among those with cardiovascular disease, 76% reported taking preventive aspirin and/or other antiplatelet medications, of whom 91% were taking preventive aspirin. Among adults without cardiovascular disease, 28% reported taking preventive aspirin. Adherence rates to medically recommended aspirin use were 82% overall, 91% for secondary prevention, and 79% for primary prevention. Among current preventive aspirin users, 70% were taking 81 milligrams (mg) of aspirin daily and 13% were taking 325 mg of aspirin daily. CONCLUSION: The vast majority of antiplatelet therapy is preventive aspirin use. A health-care provider's recommendation to take preventive aspirin is an important determinant of current preventive aspirin use. |
Diabetes and fracture risk in older U.S. adults
Looker AC , Eberhardt MS , Saydah SH . Bone 2015 82 9-15 OBJECTIVE: We examined the diabetes-fracture relationship by race/ethnicity, including the link between pre-diabetes and fracture. RESEARCH DESIGN AND METHODS: We used Medicare- and mortality-linked data for respondents aged 65years and older from the third National Health and Nutrition Examination Survey (NHANES III) and NHANES 1999-2004 for three race/ethnic groups: non-Hispanic whites (NHW), non-Hispanic blacks (NHB), and Mexican Americans (MA). Diabetes was defined as diagnosed diabetes (self-reported) and diabetes status: diagnosed and undiagnosed diabetes (positive diagnosis or hemoglobin A1c (A1C)≥6.5%); pre-diabetes (no diagnosis and A1C between 5.7% and 6.4%); and no diabetes (no diagnosis and A1C<5.7%). Non-skull fractures (n=750) were defined using published algorithms. Hazards ratios (HRs) were calculated using Cox proportional hazards models. RESULTS: The diabetes-fracture relationship differed significantly by race/ethnicity (pinteraction<0.05). Compared to those without diagnosed diabetes, the HRs for those with diagnosed diabetes were 2.37 (95% CI 1.49-3.75), 1.87 (95% CI 1.02-3.40), and 1.22 (95% CI 0.93-1.61) for MA, NHB, and NHW, respectively, after adjusting for significant confounders. HRs for diagnosed and undiagnosed diabetes were similar to those for diagnosed diabetes alone. Pre-diabetes was not significantly related to fracture risk, however. Compared to those without diabetes, adjusted HRs for those with pre-diabetes were 1.42 (95% CI 0.72-2.81), and 1.20 (95% CI 0.96-1.51) for MA and NHW, respectively. There were insufficient fracture cases to examine detailed diabetes status in NHB. CONCLUSIONS: The diabetes-fracture relationship was stronger in MA and NHB. Pre-diabetes was not significantly associated with higher fracture risk, however. |
Prevalence of nonalcoholic fatty liver disease in the United States: the Third National Health and Nutrition Examination Survey, 1988-1994
Lazo M , Hernaez R , Eberhardt MS , Bonekamp S , Kamel I , Guallar E , Koteish A , Brancati FL , Clark JM . Am J Epidemiol 2013 178 (1) 38-45 Previous estimates of the prevalence of nonalcoholic fatty liver disease (NAFLD) in the US population relied on measures of liver enzymes, potentially underestimating the burden of this disease. We used ultrasonography data from 12,454 adults who participated in the Third National Health and Nutrition Examination Survey, conducted in the United States from 1988 to 1994. We defined NAFLD as the presence of hepatic steatosis on ultrasonography in the absence of elevated alcohol consumption. In the US population, the rates of prevalence of hepatic steatosis and NAFLD were 21.4% and 19.0%, respectively, corresponding to estimates of 32.5 (95% confidence interval: 29.9, 35.0) million adults with hepatic steatosis and 28.8 (95% confidence interval: 26.6, 31.2) million adults with NAFLD nationwide. After adjustment for age, income, education, body mass index (weight (kg)/height (m)(2)), and diabetes status, NAFLD was more common in Mexican Americans (24.1%) compared with non-Hispanic whites (17.8%) and non-Hispanic blacks (13.5%) (P = 0.001) and in men (20.2%) compared with women (15.8%) (P < 0.001). Hepatic steatosis and NAFLD were also independently associated with diabetes, with insulin resistance among people without diabetes, with dyslipidemia, and with obesity. Our results extend previous national estimates of the prevalence of NAFLD in the US population and highlight the burden of this disease. Men, Mexican Americans, and people with diabetes and obesity are the most affected groups. |
Albuminuria prevalence in first morning void compared with previous random urine from adults in the National Health and Nutrition Examination Survey, 2009-2010
Saydah SH , Pavkov ME , Zhang C , Lacher DA , Eberhardt MS , Burrows NR , Narva AS , Eggers PW , Williams DE . Clin Chem 2013 59 (4) 675-83 BACKGROUND: Albuminuria, defined as urine albumin/creatinine ratio (ACR) ≥30 mg/g, is a diagnostic component of chronic kidney disease (CKD). National estimates of ACR and CKD prevalence have been based on single random urine samples. Although 2 urine samples or a first morning void are known to produce different estimates of ACR, the impact of differing urine sampling schemes on nationally estimated rates of CKD is unknown. METHODS: In 2009-2010, the National Health and Nutrition Examination Survey (NHANES) participants provided 2 untimed urine samples for sequential ACR measurement: an initial random urine collected in the NHANES mobile examination center and a subsequent first morning void collected at home. Rates of albuminuria were calculated in the overall population and broken down by demographics, diagnosed diabetes and hypertension status, and estimated glomerular filtration rate (eGFR). RESULTS: Overall, 43.5% of adults with increased ACR (≥30 mg/g) in a random urine also had increased ACR in a first morning urine. This percentage was higher among individuals ≥50 years old (48.9%), males (53.3%), participants with diagnosed diabetes (56.3%) and hypertension (51.5%), and eGFR <60 mL/min/1.72m(2) (56.9%). The use of confirmed increased ACR (defined as the presence of ACR ≥30 mg/g in both samples taken within 10 days) to define CKD resulted in a lower overall prevalence (11.6%) than first morning urine (12.7%) or random spot urine only (15.2%). CONCLUSIONS: ACR measured on random urine samples appears to overestimate the prevalence of albuminuria compared to first morning urine collections. |
Racial and ethnic differences in weight management behavior by weight perception status
Dorsey RR , Eberhardt MS , Ogden CL . Ethn Dis 2010 20 (3) 244-50 OBJECTIVE: To examine racial/ethnic differences in the relationship between weight perception and weight management behaviors among overweight and obese adults. PARTICIPANTS: The study examined a nationally representative sample of 11,319 non-Hispanic White, non-Hispanic Black and Mexican American overweight and obese adults aged > or = 20 years from the 1999-2006 National Health and Nutrition Examination Survey. DESIGN: Body mass index (BMI, defined as weight in kilograms divided by height in meters squared) was used to categorize overweight (25 < or = BMI < 30) and obesity (BMI > or = 30). Measured height and weight were used to calculate BMI. Subjects reported self-perception of weight status (correct perception and misperception) and weight management behaviors over the previous 12 months (trying to lose weight, trying not to gain weight, and having a desired weight goal). Weight perception stratified logistic regression was used to model odds of weight management behavior by race/ethnicity. RESULTS: Among overweight and obese non-Hispanic White, non-Hispanic Black, and Mexican American adults, correct weight perception was positively associated with weight management behavior. In multiple logistic regression models, overweight non-Hispanic Blacks with a weight misperception were less likely to have tried to lose weight (adjusted odds ratio [aOR] = .7; 95% confidence interval [Cl] = .5,1.0) or to have tried not to gain weight (aOR = .7; 95% CI = .5,1.0) compared to overweight non-Hispanic Whites with a weight misperception. Among the obese with a misperception, non-Hispanic Blacks were less likely to desire to weigh less compared to non-Hispanic Whites (aOR = .5; 95% CI = .3,.9). CONCLUSIONS: Weight perception was associated with weight management behaviors, and this relationship varied by race/ethnicity. Weight perception may need to be addressed among overweight and obese individuals to increase appropriate weight management behaviors, particularly among minority communities. |
Hypertension, high serum total cholesterol, and diabetes: racial and ethnic prevalence differences in U.S. adults, 1999-2006
Fryar CD , Hirsch R , Eberhardt MS , Yoon SS , Wright JD . NCHS Data Brief 2010 (36) 1-8 Eliminating health disparities among different segments of the population is one of two overarching goals of both Healthy People 2010 and 2020 (1). Race/ethnicity differences in health care and chronic diseases have been well documented (2,3). Hypertension, hypercholesterolemia, and diabetes are all chronic conditions associated with cardiovascular disease, the leading cause of death in the United States. The co-occurrence of these three chronic conditions by race/ethnicity has been less frequently documented. In addition, reliance on only self-reported diagnosis results in an underestimate of the prevalence of these conditions. The objective of this report is to compare the prevalence of diagnosed and undiagnosed hypertension, hypercholesterolemia, and diabetes among three racial/ethnic groups and the prevalence of co-morbidity of these conditions for U.S. adults. |
Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes
Plantinga LC , Crews DC , Coresh J , Miller ER 3rd , Saran R , Yee J , Hedgeman E , Pavkov M , Eberhardt MS , Williams DE , Powe NR . Clin J Am Soc Nephrol 2010 5 (4) 673-82 BACKGROUND AND OBJECTIVES: Prevalence of chronic kidney disease (CKD) in people with diagnosed diabetes is known to be high, but little is known about the prevalence of CKD in those with undiagnosed diabetes or prediabetes. We aimed to estimate and compare the community prevalence of CKD among people with diagnosed diabetes, undiagnosed diabetes, prediabetes, or no diabetes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The 1999 through 2006 National Health and Nutrition Examination Survey is a representative survey of the civilian, noninstitutionalized US population. Participants who were aged ≥20 years; responded to the diabetes questionnaire; and had fasting plasma glucose (FPG), serum creatinine, and urinary albumin-creatinine ratio measurements were included (N = 8188). Diabetes status was defined as follows: Diagnosed diabetes, self-reported provider diagnosis (n = 826); undiagnosed diabetes, FPG ≥126 mg/dl without self-reported diagnosis (n = 299); prediabetes, FPG ≥100 and <126 mg/dl (n = 2272); and no diabetes, FPG <100 mg/dl (n = 4791). Prevalence of CKD was defined by estimated GFR 15 to 59 ml/min per 1.73 m(2) or albumin-creatinine ratio ≥30 mg/g; adjustment was performed with multivariable logistic regression. RESULTS: Fully 39.6% of people with diagnosed and 41.7% with undiagnosed diabetes had CKD; 17.7% with prediabetes and 10.6% without diabetes had CKD. Age-, gender-, and race/ethnicity-adjusted prevalence of CKD was 32.9, 24.2, 17.1, and 11.8%, for diagnosed, undiagnosed, pre-, and no diabetes, respectively. Among those with CKD, 39.1% had undiagnosed or prediabetes. CONCLUSIONS: CKD prevalence is high among people with undiagnosed diabetes and prediabetes. These individuals might benefit from interventions aimed at preventing development and/or progression of both CKD and diabetes. |
Control of risk factors among people with diagnosed diabetes, by lower extremity disease status
Dorsey RR , Eberhardt MS , Gregg EW , Geiss LS . Prev Chronic Dis 2009 6 (4) A114 INTRODUCTION: We examined the control of modifiable risk factors among a national sample of diabetic people with and without lower extremity disease (LED). METHODS: The sample from the 1999-2004 National Health and Nutrition Examination Survey consisted of 948 adults aged 40 years or older with diagnosed diabetes and who had been assessed for LED. LED was defined as peripheral arterial disease (ankle-brachial index <0.9), peripheral neuropathy (> or = 1 insensate area), or presence of foot ulcer. Good control of modifiable risk factors, based on American Diabetes Association recommendations, included being a nonsmoker and having the following measurements: hemoglobin A1c (HbA1c) less than 7%, systolic blood pressure less than or equal to 130 mm Hg, diastolic blood pressure less than or equal to 80 mm Hg, high-density lipoprotein (HDL) cholesterol greater than 50 mg/dL, and body mass index (BMI) between 18.5 kg/m(2) and 24.9 kg/m(2). RESULTS: Diabetic people with LED were less likely than were people without LED to have recommended levels of HbA1c (39.3% vs 53.5%) and HDL cholesterol (29.7% vs 41.1%), but there were no differences in systolic or diastolic blood pressure, BMI classification, or smoking status between people with and without LED. Control of some risk factors differed among population subgroups. Notably, among diabetic people with LED, non-Hispanic blacks were more likely to have improper control of HbA1c (adjusted odds ratio [AOR] = 2.0; 95% confidence interval [CI], 1.1-3.9), systolic blood pressure (AOR = 1.9; 95% CI, 1.1-3.2), and diastolic blood pressure (AOR = 2.6; 95% CI, 1.1-5.8), compared with non-Hispanic whites. CONCLUSION: Control of 2 of 6 modifiable risk factors was worse in diabetic adults with LED compared with diabetic adults without LED. Among diabetic people with LED, non-Hispanic blacks had worse control of 3 of 6 risk factors compared with non-Hispanic whites. |
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