Biomedical subjects

Ike S Okosun

Publications and source records attributed to Ike S Okosun.

7 recordsLinked to original sources

PubMed2005

Hemoglobin A1c levels in diagnosed and undiagnosed black, Hispanic, and white persons with diabetes: results from NHANES 1999-2000.

PURPOSE: Although the prevalence of diabetes among various racial/ethnic groups has been well studied, little is known about the racial/ ethnic differences in Hemoglobin A1c (HbA1c) in diagnosed and undiagnosed diabetes. HbA1c correlates with morbidity and mortality in diabetes. Knowledge of the racial/ethnic differences in HbA1c would impact screening and intervention in primary care settings. This study describes racial/ethnic differences in HbA1c among US Black, Hispanic, and White diagnosed and undiagnosed persons with diabetes. METHODS: This study included participants in the 1999-2000 National Health and Nutrition Examination Survey who were > or =20 years old with a HbA1c measurement. The association between HbA1c and race in diagnosed and undiagnosed persons with diabetes (with body mass index [BMI] and age as covariates) was determined. The distribution of HbA1c and mean HbA1c in diagnosed and undiagnosed diabetes and the rates of diagnosed and undiagnosed diabetes with their corresponding HbA1c levels are described by race/ethnicity. RESULTS: Estimated diabetes prevalence in US persons > or =20 years is 8.2%, with 2.3% having undiagnosed diabetes. Whites with diabetes had lower mean HbA1c levels (7.6%, standard error [SEI 0.2) than Blacks (8.1%, SE 0.3) or Hispanics (8.2%, SE .3). Whites with diagnosed diabetes were less likely to have HbA1c> or =11% (1.7%) than Blacks (11.1%) or Hispanics (10.4%). Hispanics with undiagnosed diabetes were more likely to have HbA1c-7% (60.5%) than Blacks (39.3%) or Whites (37.8%). CONCLUSIONS: Significant numbers of persons with diabetes are undiagnosed. There are significant racial/ethnic differences in HbA1c levels, which are significantly higher in Blacks and Hispanics. Comprehensive risk-based screening and intervention for diabetes is needed in order to address racial and ethnic disparities, especially in minorities.

Analysis of Variance↗

PubMed2004

Abdominal adiposity in U.S. adults: prevalence and trends, 1960-2000.

BACKGROUND: There is a large body of epidemiologic evidence linking abdominal obesity to cardiovascular diseases. Abdominal adiposity is an important component of insulin resistance syndrome. OBJECTIVE: To investigate prevalence and trends in abdominal obesity in U.S. adult population. DESIGN, SETTING/PARTICIPANTS: Nationally representative cross-sectional surveys with an in-person interview and measurement of waist circumference; 23,654 adults aged 20-79 years were examined using data from U.S. National Surveys of 1960-1962 [the first National Health Examination Survey (NHES I)], 1988-1994 [the third National Health and Nutrition Examination Survey (NHANES III)] and 1999-2000 [National Health and Nutrition Examination Survey (NHANES 1999-2000)]. Abdominal obesity was defined as waist circumference > or = 102 cm (>40 in.) in men and > or = 88 cm (>35 in.) in women. RESULTS: There was a gradient of increasing waist circumference over the three periods of 1960-1962, 1988-1994 and 1999-2000 in both men and women. In men, the mean waist circumferences were 89, 95 and 99 cm for 1960-1962, 1988-1994 and 1999-2000, respectively. The corresponding values in women were 77, 92 and 94 cm, respectively. A gradient of increasing prevalence of abdominal obesity from 1960 to 2000 was also observed in men and women. In men, the overall age-adjusted prevalences of abdominal obesity were 12.7%, 29% and 38.3% in 1960-1962, 1988-1994 and 1999-2000, respectively. In women, the analogous values were 19.4%, 38.8% and 59.9%, respectively. Similar trends of increasing waist circumference and abdominal obesity were observed in normal weight, underweight and obese subjects defined using body mass index (BMI). Trends of increasing abdominal obesity with increasing BMI over the three time periods were also observed. CONCLUSIONS: The increase in the prevalence of abdominal obesity in the United States between 1960-1962 and 1999-2000 has ominous public health implications across entire population, particularly among normal weight subjects. There is an urgent need to describe a public health strategy for early identification of abdominal obesity. Primary prevention of obesity, including abdominal obesity, should be a major public health priority in the United States.

Abdomen↗

PubMed2004

Do volunteer community-based preceptors value students' feedback?

PURPOSE: A key component of educational practice is to provide feedback and evaluation to teachers and learners to improve the teaching and learning process. The purpose of this study was to determine whether volunteer community preceptors value evaluation and feedback by students as much as they value other resources or rewards. METHOD: In Fall 1999, a questionnaire concerning the resources and rewards of preceptorship was mailed to 236 community preceptors affiliated with the Mercer University School of Medicine, Macon, Georgia. Preceptors were asked to rate 20 factors on a five-point Likert scale (5 = very important to 1 = not very important). The mean values were compared using t-tests. RESULTS: One hundred sixty-eight preceptors (71%) completed questionnaires. Preceptors rated evaluation and feedback from students significantly higher (p < .001) than all other factors (mean = 4.02, standard deviation [SD] = .87). Continuing medical education for teaching was the next most highly valued factor (mean = 3.67, SD = 1.14). Preceptors rated financial compensation the lowest (mean = 2.01, SD = 1.19) of all factors. The high rank of feedback and evaluation from students persisted across gender, specialty, length of time as a preceptor, practice location, and years practicing medicine. CONCLUSION: This study demonstrates that feedback and evaluation from students is highly valued. The knowledge that community-based preceptors highly value feedback and evaluation from students should stimulate medical school programs to provide feedback and evaluation to preceptors that will enhance the educational outcomes for both faculty and learners.

Data Collection↗

PubMed2003

Trends of abdominal adiposity in white, black, and Mexican-American adults, 1988 to 2000.

OBJECTIVE: To describe changes in the distribution of waist circumference (WC) and abdominal obesity (AO) in white, black, and Mexican-American adults from 1988 through 2000. RESEARCH METHODS AND PROCEDURES: Nationally representative cross-sectional surveys of adults 20 to 79 years of age were examined using data from U.S. National Health and Nutrition Examination Surveys of 1988 to 1994 and 1999 to 2000. AO was defined as WC > or =102 cm in men and > or 88 cm in women. RESULTS: There was a gradient of increasing WC and AO with increasing age in both study periods in whites and blacks. In men, the average increase between the study periods in overall WC in whites, blacks, and Mexican Americans were 3, 3.3, and 3.4 cm, respectively. The corresponding values in women were 2.4, 5.3, and 3.7 cm, respectively. In men, the percentage change in prevalence of AO between 1988 and 2000 ranged from 5.5% in Mexican-American men to 8.2% in white men. In women, there was a 1.7% decrease in AO in Mexican Americans, whereas there was an increase of 6.3% for whites and 7% for blacks. DISCUSSION: Despite increased understanding of the need for screening and treatment for obesity, this study indicates increasing prevalence of AO in white and black Americans. Without concerted effort to reduce the prevalence of overall obesity, the increasing prevalence of AO is likely to lead to increased prevalence of metabolic syndromes in the United States. Our results highlight the need to design evidence-based programs that show promise for long-term health behavior changes to facilitate the prevention of AO and related comorbidities.

Abdomen↗

PubMed2003

Diagnosed diabetes and ethnic disparities in adverse health behaviors of American women.

Despite higher rates of some high-risk lifestyle factors in non-Hispanic black women compared to non-Hispanic white women, no data exist examining the role of diagnosed diseases. Having diabetes diagnosed might motivate women and their providers to work together to lower the women's levels of behavioral risk factors. The purpose of this study was to determine the association between diagnosed diabetes and adverse health behaviors, including smoking, alcohol consumption, and sedentary lifestyle in non-Hispanic white (n=270) and non-Hispanic black (n=149) women with type 2 diabetes. Diagnosed diabetes was defined as answering "yes" to the Third US National Health and Nutrition Examination Survey question: "Have you ever been told by a doctor that you have diabetes or sugar diabetes?" Logistic regression analyses were used to determine the association of diagnosed diabetes with the adverse health behaviors. In this study, non-Hispanic black diabetic women had higher prevalences of smoking, sedentary lifestyle, and lower rates of diagnosed diabetes compared with non-Hispanic white women (P<0.01). Relative to non-Hispanic diabetic white, non-Hispanic diabetic black was associated respectively with 25% and 58% increased odds of smoking and sedentary lifestyle, adjusting for diagnosed diabetes and other confounding variables. Approximately 15% of alcohol consumption and 13% excess sedentary lifestyle in non-Hispanic diabetic blacks were associated with their increased rates of diagnosed diabetes relative to non-Hispanic diabetic whites. These excesses in adverse health behaviors, however, were within what can be explained by chance variation. There were non-significant trends toward less smoking and more sedentary lifestyle. Thus, diabetic women with a diagnosis generally had a worse behavioral risk profile than those without a diagnosis even after controlling multiple confounders. This shows the need for physicians to educate their diabetic patients regarding benefits of exercise and smoking avoidance.

Black or African American↗

PubMed2002

Abdominal obesity and ethnic differences in diabetes awareness, treatment, and glycemic control.

OBJECTIVE: To compare racial/ethnic differences in diabetes awareness, treatment, and glycemic control between non-Hispanic white, non-Hispanic black, and Hispanic Americans. We also determined the impact of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control between these population groups. RESEARCH METHODS AND PROCEDURES: Third National Health and Nutrition Examination Survey (NHANES III) data were utilized for this study. Diabetes awareness was defined as acknowledging diabetic status. Diabetes treatment was defined as current use of anti-diabetic medications, good glycemic control as HbA(1c) < 8%, and abdominal obesity as waist circumference larger than expected. The impacts of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control were assessed using logistic regression analyses. Adjustments were made for age, education, smoking, alcohol intake, and health insurance. RESULTS: Rates of diabetes awareness in whites, blacks, and Hispanics suffering from abdominal obesity were approximately 74%, 30%, and 21% in men and 77%, 32%, and 19% in women, respectively. Rates of diabetes treatment were 70%, 23%, and 14% in men and 57%, 45%, and 23% in women, respectively. In men, rates of glycemic control were 64%, 40%, and 30%, and in women, they were 62%, 51%, and 27%, respectively. Abdominal obesity was associated with decreased diabetes awareness and glycemic control in women. DISCUSSION: Subjects with abdominal obesity were found to have poorer glycemic controls compared to those without abdominal obesity. Because diabetes prevalences were partially explained by racial/ethnic differences in diabetes awareness, treatment, and glycemic control, there is a need to craft diabetes awareness, treatment, and control programs along racial/ethnic origins.

Abdomen↗

PubMedDate not supplied

Serum carotenoids and clustering of adverse health behaviors in American adults.

OBJECTIVE: To determine the association between clustering of adverse health behaviors (cigarette smoking, alcohol intake, and sedentarism) and serum carotenoids in a representative sample of white, Black, and Hispanic Americans. METHODS: Data (n=6,218) from the Third US National Health and Nutrition Examination Survey were utilized for this investigation. Adjusted gender-specific linear regression analyses were used. RESULTS: Increase in clustering of adverse health behaviors was associated with decreased serum concentrations of a-carotene, b-carotene, bcryptoxanthine, and luteine/zeaxanthene in the 3 racial/ethnic groups (P<0.05). CONCLUSION: Persons with multiple adverse health behaviors should be advised to increase fruit and vegetable consumption, as primary sources of chemopreventive antioxidants.

Adult↗