Project Title

Individual and contextual factors associated with subclinical atherosclerosis in diabetes patients in rural Central Appalachia

Authors' Affiliations

Fenose Osedeme-Community and Behavioral Health Department, College of Public Health, East Tennessee State University, Johnson City, TN. Sylvester Orimaye- Biostatistics Department, College of Public Health, East Tennessee State University, Johnson City, TN. Antwan Jones- Department of Sociology, The George Washington University, Washington, DC Timir K. Paul-College of Medicine, East Tennessee State University, Johnson City, TN. Jerry G. Blackwell- Ballad Health, Kingsport, TN Matthew Budoff-Cardiology, Los Angeles Biomedical Research Institute, Torrance, CA Hadii M. Mamudu-Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN

Location

Ballroom

Start Date

4-5-2018 8:00 AM

End Date

4-5-2018 12:00 PM

Poster Number

55

Name of Project's Faculty Sponsor

Dr. Hadii M. Mamudu

Faculty Sponsor's Department

College of Public Health, Health Services Management and Policy

Type

Poster: Competitive

Classification of First Author

Graduate Student-Master’s

Project's Category

Social and Behavioral Sciences

Abstract Text

Background: The prevalence of diabetes is disproportionately distributed in Central Appalachia compared with other regions in the U.S. Previous research reveals that nearly 65% and 17% of patients with diabetes reported having history of cardiovascular heart disease (CHD) and coronary artery disease (CAD) respectively. This study examined the prevalence of factors associated with subclinical atherosclerosis (measured as coronary artery calcium) in patients with diabetes in geographic locations of rural Central Appalachia.

Methods: The study population consisted of 2479 asymptomatic individuals from the rural Central Appalachian region of Kentucky, North Carolina, Tennessee, and Virginia between August 2012 and November 2016. Descriptive analysis was completed for the total sample size with sub analysis of individuals with diabetes. T-test was used for comparison of categorical (example: hypertension and physical inactivity) and continuous variables (example: age and BMI), respectively. In addition, multinomial logistic regression was conducted to assess the association between multiple risk factors including CAC scores, and geographic locations of patients with diabetes in rural Central Appalachia.

Results: There was no significant difference between ages for diabetic and non-diabetic patients. Individual factors which are associated with diabetes include current CAC score (p<0.001, CI: 45.90 – 189.98), BMI (p<0.001, CI: 3.01 – 5.64), sedentary lifestyle (p<0.005, CI: 0.039 – 0.215), history of CAD (p<0.001, CI: 0.08 - 0.19), hypercholesterolemia (p<0.001, CI: 0.64 – 0.23), and hypertension (p<0.001, CI: 0.18 – 0.34). There was no significant correlation between geographic locations and diabetes. Among male and female genders, hypertension, hypercholesterolemia, history of CAD, sedentary lifestyle, current CAC score, and BMI have a significant positive correlation with diabetes except for self-reported obesity which only has a significant positive correlation with the female gender.

Conclusion: Individual factors remain associated with diabetes across the male and female genders regardless of the geographic locations of the diabetic patients in rural Appalachia. There is strong evidence that cardiovascular related factors could be associated with diabetes across both genders in rural Central Appalachia. We suggest the implementation of evidence-based public health strategies to address the modifiable behaviors that can improve the health of people in rural Central Appalachia.

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Apr 5th, 8:00 AM Apr 5th, 12:00 PM

Individual and contextual factors associated with subclinical atherosclerosis in diabetes patients in rural Central Appalachia

Ballroom

Background: The prevalence of diabetes is disproportionately distributed in Central Appalachia compared with other regions in the U.S. Previous research reveals that nearly 65% and 17% of patients with diabetes reported having history of cardiovascular heart disease (CHD) and coronary artery disease (CAD) respectively. This study examined the prevalence of factors associated with subclinical atherosclerosis (measured as coronary artery calcium) in patients with diabetes in geographic locations of rural Central Appalachia.

Methods: The study population consisted of 2479 asymptomatic individuals from the rural Central Appalachian region of Kentucky, North Carolina, Tennessee, and Virginia between August 2012 and November 2016. Descriptive analysis was completed for the total sample size with sub analysis of individuals with diabetes. T-test was used for comparison of categorical (example: hypertension and physical inactivity) and continuous variables (example: age and BMI), respectively. In addition, multinomial logistic regression was conducted to assess the association between multiple risk factors including CAC scores, and geographic locations of patients with diabetes in rural Central Appalachia.

Results: There was no significant difference between ages for diabetic and non-diabetic patients. Individual factors which are associated with diabetes include current CAC score (p<0.001, CI: 45.90 – 189.98), BMI (p<0.001, CI: 3.01 – 5.64), sedentary lifestyle (p<0.005, CI: 0.039 – 0.215), history of CAD (p<0.001, CI: 0.08 - 0.19), hypercholesterolemia (p<0.001, CI: 0.64 – 0.23), and hypertension (p<0.001, CI: 0.18 – 0.34). There was no significant correlation between geographic locations and diabetes. Among male and female genders, hypertension, hypercholesterolemia, history of CAD, sedentary lifestyle, current CAC score, and BMI have a significant positive correlation with diabetes except for self-reported obesity which only has a significant positive correlation with the female gender.

Conclusion: Individual factors remain associated with diabetes across the male and female genders regardless of the geographic locations of the diabetic patients in rural Appalachia. There is strong evidence that cardiovascular related factors could be associated with diabetes across both genders in rural Central Appalachia. We suggest the implementation of evidence-based public health strategies to address the modifiable behaviors that can improve the health of people in rural Central Appalachia.