Aims/Introduction
Postmenopausal women receive bisphosphonates for osteoporosis treatment. The effect of these medications on developing diabetes mellitus in prediabetic patients is yet to be investigated. We aimed to determine the effect of alendronate on plasma glucose, insulin indices of postmenopausal women with prediabetes and osteopenia.
Materials and Methods
The present triple‐blind randomized controlled clinical trial included 60 postmenopausal women, aged 45–60 years. All patients were vitamin D sufficient. They were randomly enrolled in intervention (70 mg/week alendronate for 12 weeks) and control (placebo tablet per week for 12 weeks) groups. The morning 8‐h fasting blood samples were collected at the baseline and follow‐up visits to measure the fasting plasma glucose (mg/
dL
), insulin and hemoglobin A1c (HbA1c). Plasma glucose and insulin concentration were measured 30, 60 and 120 min after the glucose tolerance test. The Matsuda Index, homeostasis model assessment of insulin resistance, homeostasis model assessment of β‐cell function and the area under the curves of glucose and insulin were calculated.
Results
The mean (standard deviation) fasting plasma glucose (102.43 [1.46] mg/
dL
vs 94.23 [1.17] mg/
dL
,
P
= 0.001), 120‐min insulin concentration (101.86 [15.70]
mU
/L vs 72.60 [11.36]
mU
/L,
P
= 0.026), HbA1c (5.60 [0.06]% vs 5.40 [0.05]%,
P
= 0.001), homeostasis model assessment of insulin resistance (3.57 [0.45] vs 2.62 [0.24],
P
= 0.021) and Matsuda Index (7.7 [0.41] vs 9.2 [0.4],
P
= 0.001) significantly improved in the alendronate‐treated group. There were more statistically significant reductions in fasting plasma glucose (−8.2 [8.63] mg/
dL
vs −2.5 [14.26] mg/
dL
,
P
= 0.002) and HbA1c (−0.2 [0.23]% vs −0.09 [0.26]%,
P
= 0.015) observed in the alendronate‐treated group than the placebo group during the study course, respectively.
Conclusions
Administration of 70 mg/week alendronate improves fasting plasma glucose, HbA1c and insulin indices in postmenopausal women.
Background
Moderately increased albuminuria (MIA) is strongly associated with hypertension (HTN) in patients with type 2 diabetic mellitus (T2DM). However, the association between risk factors and coexisting HTN and MIA remains unassessed.
Objectives
This study aimed to determine both cross-sectional and longitudinal associations of risk factors with HTN and MIA comorbidity in patients with T2DM.
Methods
A total of 1,600 patients with T2DM were examined at baseline and longitudinal data were obtained from 1,337 T2DM patients with at least 2 follow-up visits to assess the presence of HTN alone (yes/no), MIA alone (yes/no) and the coexistence of both (yes/no) in a 9-year open cohort study between 2004 and 2013. Bivariate mixed-effects logistic regression with a Bayesian approach was employed to evaluate associations of risk factors with HTN and MIA comorbidity in the longitudinal assessment.
Results
After adjustment for age and BMI, patients with uncontrolled plasma glucose, as a combined index of the glucose profile, were more likely to have HTN [odds ratio (OR): 1.73 with 95% Bayesian credible intervals (BCI) 1.29–2.20] and MIA [OR: 1.34 (95% BCI 1.13–1.62)]. The risks of having HTN and MIA were increased by a one-year raise in diabetes duration [with 0.89 (95% BCI 0.84–0.96) and 0.81 (95% BCI 0.73–0.92) ORs, respectively] and a one-unit increase in non-high-density lipoprotein-cholesterol (Non-HDL-C) [with 1.30 (95% BCI 1.23–1.34) and 1.24 (95% BCI 1.14–1.33) ORs, respectively].
Conclusions
T2DM patients with HTN, MIA, and the coexistence of both had uncontrolled plasma glucose, significantly higher Non-HDL-C, and shorter diabetes duration than the other T2DM patients. Duration of diabetes and uncontrolled plasma glucose index showed the stronger effects on HTN and MIA comorbidity than on each condition separately.
Depression, anxiety and stress are common psychological disorders (PDs). This study aimed to assess the odds of co-occurrence of mentioned PDs in total sample and different levels of socio-demographic characteristics, specifically among a large sample of general adults. In a cross-sectional, community-based study conducted among 4763 Iranian adults, depression and anxiety were assessed with Hospital Anxiety and Depression Scale (HADS) and stress with General Health Questionnaire (GHQ). The loglinear analysis was applied to investigate their comorbidities. Based on selected models with pair-comorbidity of anxiety with stress, depression with stress, and anxiety with depression, the results showed the odds of comorbidity between anxiety and depression (odds ratio (OR) =12.29, 95%CI: 9.58-15.80), depression and stress (OR = 7.80, 95%CI: 6.55-10.18), and stress and anxiety (OR = 4.62, 95%CI: 3.71-5.75). Also, ORs of pair-comorbidities were the same, except between stress and anxiety for men compared to women (adjusted-OR = 6.47, 95%CI: 4.44-9.49 versus 3.85, 95%CI: 2.95-5.00) and comorbidity between stress and depression for the participants with lower than 40 years compared to others (adjusted-OR = 9.03, 95%CI: 7.17-11.36 versus 6.41, 95%CI: 4.90-8.41), p< 0.05. Stress comorbidity with depression was higher level than other pair-comorbidities. Obvious discrepancies were also observed in terms of ORs of pair-comorbidities between three mentioned disorders in different levels of SDCs.
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