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All Journal Medicinus : Jurnal Kedokteran
Jessica Adrya
Department of Internal Medicine, RSUD dr. T.C. Hillers, Indonesia
Medicine & Pharmacology Public Health

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Impact of Socioeconomic Inequalities on the Incidence of Type 2 Diabetes Mellitus: A Systematic Review Calvin Sasongko; Jessica Adrya; Srigita Varsha; Sony A. Fatchurrahman; Galih Muchlis Hermawan; Veriantara Satya Dhika; Teddy Tjahyanto; Natania Eliadi
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10972

Abstract

ckground: Type 2 diabetes mellitus (T2DM) is a rising global burden, and socioeconomic inequalities may shape risk through differential resources, environments, and access to prevention and care. We synthesised evidence on the association between socioeconomic position (SEP) and incident T2DM. Methods: We conducted a PRISMA 2020–guided systematic review of PubMed, EMBASE, and Scopus (inception to 18 January 2026). Observational studies of adults without diabetes at baseline that measured SEP (education, income, occupation and/or area deprivation) prior to diagnosis and reported incident T2DM were eligible. Random-effects meta-analyses pooled relative risks (RRs), treating hazard ratios as approximations. Risk of bias was assessed (NOS). Result: From 1,580 records, 25 studies met inclusion criteria and 23 contributed to quantitative synthesis. Studies were mainly prospective cohorts or nested case–control designs, largely from high-income countries, with follow-up from 3 to 34 years and participants aged 18–86 years. Lower education was associated with higher T2DM incidence (least vs most educated: RR 1.55, 95% CI 1.37–1.75). Lower occupational position was also associated with increased risk (lowest vs highest: RR 1.60, 95% CI 1.25–2.05). Income was not statistically conclusive (lowest vs highest: RR 1.37, 95% CI 0.94–2.01). Conclusions: Socioeconomic disadvantage, particularly lower education and occupational status, is consistently associated with higher risk of incident T2DM. Prevention and screening should incorporate SEP to better target upstream determinants.
Prognostic Significance of Hypoalbuminemia in Transcatheter Aortic Valve Implantation Patients: A Systematic Review and Meta Analysis of Diagnostic Test Accuracy Destino Huvi; Jessica Adrya; Nihal Sofyan; Daffa Rizqi Fauzi; Alan Dharmasaputra; Srigita Varsha; Putri Dhiya Prameswari Wiyono
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10973

Abstract

ckground: Calcific aortic stenosis is common in older adults, and TAVR has expanded treatment to patients with high comorbidity and frailty. Serum albumin is an inexpensive marker that reflects inflammation, nutrition, and physiologic reserve, but its prognostic performance in TAVR needs clearer quantification. Methods: We performed a PRISMA/PRISMA-DTA–guided systematic review and diagnostic test accuracy meta-analysis of studies evaluating pre-procedural hypoalbuminemia in adults undergoing TAVR/TAVI. PubMed, Embase, and Scopus were searched from inception to 18 January 2026. Hierarchical models were used to pool sensitivity and specificity for 30-day mortality, and a random-effects model pooled hazard ratios for time-to-event mortality. Risk of bias was assessed using PROBAST. Result: Ten studies met inclusion criteria. Definitions of hypoalbuminemia varied (most commonly <3.3–3.5 g/dL). For predicting 30-day mortality, pooled sensitivity was 47.7% (95% CI 35.5–59.9) and pooled specificity was 76.0% (95% CI 62.9–89.2), indicating better rule-in than rule-out performance. Across studies reporting time-to-event outcomes, hypoalbuminemia was associated with higher mortality (pooled HR 1.15, 95% CI 1.03–1.29). PROBAST ratings were generally low risk for participants, predictors, and outcomes, with some concerns in the analysis domain. Conclusions: Pre-procedural hypoalbuminemia is a practical risk marker in TAVR patients, showing moderate specificity for early mortality and a consistent association with worse survival, supporting its use in peri-procedural risk stratification.
Co-Authors Alan Dharmasaputra Calvin Sasongko Daffa Rizqi Fauzi Destino Huvi Galih Muchlis Hermawan Natania Eliadi Nihal Sofyan Putri Dhiya Prameswari Wiyono Sony A. Fatchurrahman Srigita Varsha Teddy Tjahyanto Veriantara Satya Dhika