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Prevalence and risk factors for obstructive sleep apnea in a multiethnic population of patients presenting for bariatric surgery in Singapore

Lee YH, Johan A, Wong KK, Edwards N, Sullivan C

Sleep Med, 2009 Feb;10(2):226-32.
PMID: 18387341 DOI: 10.1016/j.sleep.2008.01.005

INTRODUCTION: Obesity is becoming more prevalent world wide. Bariatric surgery is one treatment option for patients with severe or morbid obesity. There have been few comprehensive studies examining prevalence and risk factors for obstructive sleep apnea (OSA) in the multiracial Singaporean bariatric surgery population.
METHODS: We performed full polysomnography on 176 consecutive patients undergoing assessment for bariatric surgery. Questionnaires regarding snoring, the presence of witnessed apneas and the Epworth Sleepiness Scale (ESS) were administered. Anthropometric and demographic measurements include age, sex, race, body mass index (BMI) and neck circumference.
RESULTS: The prevalence of OSA was 72%, and 49% of the 176 patients had an AHI >= 15. There was a male predominance of OSA (X(2) = 29.7; p<0.001). OSA subjects had larger neck circumference (43.9 +/- 4.5 vs. 39.4 cm +/- 3.3; p<0.001) and higher BMI (43.1 +/- 7.6 vs. 39.1 +/- 5.4 kg/m(2); p<0.001). The neck circumference (OR = 1.37; p<0.001), presence of snoring (OR = 8.25; p<0.001) and an ESS >10 (OR = 3.24; p = 0.03) were significant independent predictors of an AHI >= 15. A neck circumference of 43 cm had an 80% sensitivity and 83% specificity for predicting an AHI >= 15.
CONCLUSIONS: OSA is common amongst Singaporeans undergoing evaluation for bariatric surgery, with a high prevalence of moderate and severe disease. An increased neck circumference is a strong independent predictor for an AHI >= 15, with a neck circumference of greater than 43 cm being a sensitive and specific predictor. Race was not found to be a risk factor.
Fulltext Diabetic endothelial colony forming cells have the potential for restoration with glycomimetics

Langford-Smith AWW, Hasan A, Weston R, Edwards N, Jones AM, Boulton AJM, et al.

Sci Rep, 2019 02 19;9(1):2309.
PMID: 30783159 DOI: 10.1038/s41598-019-38921-z

Endothelial colony forming progenitor cell (ECFC) function is compromised in diabetes, leading to poor vascular endothelial repair, which contributes to impaired diabetic foot ulcer healing. We have generated novel glycomimetic drugs with protective effects against endothelial dysfunction. We investigated the effect of glycomimetic C3 on the functional capacity of diabetic ECFCs. ECFCs were isolated from healthy controls and patients with diabetes with neuroischaemic (NI) or neuropathic (NP) foot ulcers. Functionally, diabetic ECFCs demonstrated delayed colony formation (p
Fulltext Developing consensus measures for global programs: lessons from the Global Alliance for Chronic Diseases Hypertension research program

Riddell MA, Edwards N, Thompson SR, Bernabe-Ortiz A, Praveen D, Johnson C, et al.

Global Health, 2017 03 15;13(1):17.
PMID: 28298233 DOI: 10.1186/s12992-017-0242-8

BACKGROUND: The imperative to improve global health has prompted transnational research partnerships to investigate common health issues on a larger scale. The Global Alliance for Chronic Diseases (GACD) is an alliance of national research funding agencies. To enhance research funded by GACD members, this study aimed to standardise data collection methods across the 15 GACD hypertension research teams and evaluate the uptake of these standardised measurements. Furthermore we describe concerns and difficulties associated with the data harmonisation process highlighted and debated during annual meetings of the GACD funded investigators. With these concerns and issues in mind, a working group comprising representatives from the 15 studies iteratively identified and proposed a set of common measures for inclusion in each of the teams' data collection plans. One year later all teams were asked which consensus measures had been implemented.
RESULTS: Important issues were identified during the data harmonisation process relating to data ownership, sharing methodologies and ethical concerns. Measures were assessed across eight domains; demographic; dietary; clinical and anthropometric; medical history; hypertension knowledge; physical activity; behavioural (smoking and alcohol); and biochemical domains. Identifying validated measures relevant across a variety of settings presented some difficulties. The resulting GACD hypertension data dictionary comprises 67 consensus measures. Of the 14 responding teams, only two teams were including more than 50 consensus variables, five teams were including between 25 and 50 consensus variables and four teams were including between 6 and 24 consensus variables, one team did not provide details of the variables collected and two teams did not include any of the consensus variables as the project had already commenced or the measures were not relevant to their study.
CONCLUSIONS: Deriving consensus measures across diverse research projects and contexts was challenging. The major barrier to their implementation was related to the time taken to develop and present these measures. Inclusion of consensus measures into future funding announcements would facilitate researchers integrating these measures within application protocols. We suggest that adoption of consensus measures developed here, across the field of hypertension, would help advance the science in this area, allowing for more comparable data sets and generalizable inferences.

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