Anthropometric, biochemical and actigraphic characteristics of a population sample of randomly selected adult rural residents of Ukraine who were not diagnosed with «diabetes mellitus» at the time of the study

Abstract

Classical «field» epidemiological studies on risk factors for diabetes and cardiovascular disease are still rare in Ukraine, so the assessment of the prevalence of type 2 diabetes mellitus (DM2) is based on extrapolations from foreign studies. Objective methods of measuring physical activity (PA), which is considered one of the main factors in the prevention of diabetes, are little known in Ukraine. In particular, it has not been clarified how common it is among the adult population of Ukraine to follow the recommendations of the World Health Organization (WHO) on the minimum amount of moderate physical activity (150 minutes per week). The question of the relationship between body composition and characteristics that affect the risk of developing DM2 remains poorly understood. Material and methods. Our study presents an analysis of biochemical, anthropometric and actigraphic characteristics of 50 (16 men with a median age of 63.5 years, 34 women with a median age of 58.0 years) of randomly selected rural residents of Kyiv region of Ukraine, in whom diabetes mellitus 2 was not known. After obtaining informed consent, all subjects underwent an oral glucose tolerance test (OGTT) according to the WHO method (1999). Measured fasting plasma glucose (FPG), plasma glucose 2 hours after standard exercise (2 hours plasma glucose, 2hPG), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), glycated hemoglobin (HbA1c), body mass index (BMI), neck circumference (NC), waist circumference (WC) and hip circumference (HC). Indicators of body composition were determined using the method of bioelectric impedance: measured the proportion of body fat (body fat, %) and total body water (%). Actigraphic measurements were performed by accelerometry using ActiGraph software. PA was monitored for 7 days on the following indicators: average metabolic equivalents (MET’s), the proportion of moderate-intensity PA for the entire time of wearing and recording the accelerometer (moderate
physical activity, ModPA, %) and continuous moderate PA per week, accumulated in periods of at least 10 minutes (ModPA, min/week). Statistical processing of the results was performed using the MedStat package. Results. Among all subjects according to OGTT and HbA1c measurements, diabetes was detected in 4 people (8%). Impaired fasting glucose (IFG) according to the American Diabetes Association (FPG 5.6-6.9 mmol/L) was detected in 21 individuals, and according
to the WHO criteria (6.1-6.9 mmol/L) — in 7 people. Regardless of the criteria used, IFG does not show a relationship with PA levels. Impaired glucose tolerance (IGT): 2hPG 7.8-11.0 mmol/L) was detected in 5 people. No association with PA was observed for glycemia, HbA1c and lipids. Women did not differ in age from men, had a higher BMI (35.08±5.53 vs. 27.43±4.98, p<0.001) and a higher proportion of body fat (45.8±5.7% vs. 26.3±5.5%, means±SD, p<0.001). PA rates in men and women did not differ, were very low and had a moderate negative correlation with age (p<0.05). Only one man and two women achieved the recommended PA level (150 minutes of moderate PA/week). However, among people with IGT, the number of PA was lower: MET’s — 1.22±0.07 vs. 1.32±0.19, p=0.023; moderate PA — 6.95±2.3% vs. 10.41±6.43%, p=0.020. Conclusions. The prevalence of previously undiagnosed diabetes mellitus is close to the results of our previous studies and current estimates of the prevalence of diabetes mellitus in the adult population in the world. The level of PA assessed by objective
actigraphy was lower in the IGT group. Further research will be able to clarify the preventive effectiveness of PA in different risk groups for diabetes.