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Diabetes mellitus (DM) and osteoporosis/osteopenia affect millions of people globally and are major health conditions in several countries including Qatar. Bone mineral density (BMD) is a widely accepted indicator for diagnosing osteoporosis (OP) and osteopenia (OPN). The best method for determining bone mineral density and OP/OPN risk is via dual energy X-ray absorptiometry (DXA) technology. The risk of osteoporosis-related fracture may increase for people with diabetes. Therefore, it is necessary to develop a system that can support the early detection of OP/OPN in diabetic patients. In this study, we analyzed Qatar diabetic cohorts including 500 subjects, among which 68 were OP/OPN (target) subjects and 432 were without osteoporosis/osteopenia (control) subjects. The objective of this study is to develop an ML model to distinguish diabetic OP/OPN patients from diabetic non-OP/non-OPN subjects based on their bone health indicators from full body DXA scan measurements. Based on our experiments, AdaBoost model performed the best for classifying the target group from the control group. 10-fold cross validation-based results indicate that the proposed ML model was able to distinguish the target group from the control group at 80% sensitivity, 96% specificity. To the best of our knowledge, our study is the first ML-based approach to detect the early onset of OP/OPN in diabetic cohort from Qatar. Our analyses revealed the higher level of lean mass, fat mass and bone mass for the control group compared to the target group. Higher levels of BMC, BMD from different body parts in the control group compared to the osteoporosis/osteopenia group indicate the protective effects of obesity on bone health in the Qatari diabetic cohort. Moreover, higher value of anthropometric measurements in troch, lumbar spine (L1, L2, L3, L4), pelvis and other body parts in the control group indicates that the WHO guideline can be applied to the Qatari diabetic cohort for the early detection of OP/OPN based on the proposed ML model. Further research on OP/OPN in diabetic patients is warranted in future to confirm the role of DM on bone health.
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Cardiovascular diseases (CVD) are the leading cause of death worldwide. People affected by CVDs may go undiagnosed until the occurrence of a serious heart failure event such as stroke, heart attack, and myocardial infraction. In Qatar, there is a lack of studies focusing on CVD diagnosis based on non-invasive methods such as retinal image or dual-energy X-ray absorptiometry (DXA). In this study, we aimed at diagnosing CVD using a novel approach integrating information from retinal images and DXA data. We considered an adult Qatari cohort of 500 participants from Qatar Biobank (QBB) with an equal number of participants from the CVD and the control groups. We designed a case-control study with a novel multi-modal (combining data from multiple modalities—DXA and retinal images)—to propose a deep learning (DL)-based technique to distinguish the CVD group from the control group. Uni-modal models based on retinal images and DXA data achieved 75.6% and 77.4% accuracy, respectively. The multi-modal model showed an improved accuracy of 78.3% in classifying CVD group and the control group. We used gradient class activation map (GradCAM) to highlight the areas of interest in the retinal images that influenced the decisions of the proposed DL model most. It was observed that the model focused mostly on the centre of the retinal images where signs of CVD such as hemorrhages were present. This indicates that our model can identify and make use of certain prognosis markers for hypertension and ischemic heart disease. From DXA data, we found higher values for bone mineral density, fat content, muscle mass and bone area across majority of the body parts in CVD group compared to the control group indicating better bone health in the Qatari CVD cohort. This seminal method based on DXA scans and retinal images demonstrate major potentials for the early detection of CVD in a fast and relatively non-invasive manner.