A Comparative Study of Linear and Quadratic Spline Regression Models for Predicting HbA1c Levels in Patients with Diabetes Mellitus

In this globalization era, health is the most important thing to be able to run various activities. Without good health, this will hinder many activities. Diabetes mellitus is one of the diseases caused by unhealty lifestyle.There are many treatments that can be done to prevent the occurrence of diabetes. The treatments are giving the insulin and also checking the glucose rate to the patients.Checking the glucose rate needs the tools which is safety to the body. This research want to develop non invasive tool which is safety and do not injure the patient. The purpose of this research is also finding the best model which derived from Linear, Quadratic, and Cubic Spline Regression. Some respondents were taking to get the glucose measuring by invasive and non invasive tools. It could be seen clearly that Spline Linear Regression was the best model than Quadratic and Cubic Spline Regression. It had 70% and 33.939 for R2 and RMSEP respectively.

This paper examines the use of spline functions in linear, squared, and cubic spline regression models and exhibits the estimation of spline parameters from data by ordinary least squares. Determination of the number and the location of knots is central to spline regression. In this paper, we initially propose a method based on the coefficient of determination R2 related to the estimation of knots in spline regression. This proposed method as applied to export–import ratio distributions in Turkey for the years 1923–2010 determines the knots, and linear, quadratic, and cubic spline regression models are established accordingly. Results reveal that spline regression models offer better results than polynomial regression models, and that the quadratic spline regression model is the best explanatory model for export–import ratio distributions in the smoothest spline regression models.

There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and this study aimed to assess feasibility and results of screening patients with TB for DM within the routine healthcare setting of six health facilities. Agreement on how to screen, monitor and record was reached in May 2011 at a stakeholders' meeting, and training was carried out for staff in the six facilities in July 2011. Implementation started in September 2011, and we report on 7 months of activities up to 31 March 2012. There were 8886 registered patients with TB. They were first asked whether they had DM. If the answer was no, they were screened with a random blood glucose (RBG) followed by fasting blood glucose (FBG) in those with RBG ≥ 6.1 mm (one facility) or with an initial FBG (five facilities). Those with FBG ≥ 7.0 mm were referred to DM clinics for diagnostic confirmation with a second FBG. Altogether, 1090 (12.4%) patients with DM were identified, of whom 863 (9.7%) had a known diagnosis of DM. Of 8023 patients who needed screening for DM, 7947 (99%) were screened. This resulted in a new diagnosis of DM in 227 patients (2.9% of screened patients), and of these, 226 were enrolled to DM care. In addition, 575 (7.8%) persons had impaired fasting glucose (FBG 6.1 to <7.0 mm). Prevalence of DM was significantly higher in patients in health facilities serving urban populations (14.0%) than rural populations (10.6%) and higher in hospital patients (13.5%) than those attending TB clinics (8.5%). This pilot project shows that it is feasible to screen patients with TB for DM in the routine setting, resulting in a high yield of patients with known and newly diagnosed disease. Free blood tests for glucose measurement and integration of TB and DM services may improve the diagnosis and management of dually affected patients.

ABSTRACTBackground: Patients with diabetes often do not reach recommended lipid targets. This may be in part due to the difficulty of obtaining fasting measurements.Objective: To compare fasting and nonfasting low density lipoprotein cholesterol (LDLc), non-high density lipoprotein cholesterol (non-HDLc), and low density lipoprotein particle number (LDLP) patients with type 2 diabetes (T2DM) and to determine the effect on assessing treatment success.Research design and methods: Standard lipids and NMR lipoproteins were analyzed at baseline and following a standardized meal in patients with T2DM.Outcomes measures: Primary outcomes were agree­ment between fasting and nonfasting LDLc, non-HDLc, and LDLP and the agreement between these measures for determining fasting LDLc treatment success. Direct LDL cholesterol (DLDL) was a secondary outcome.Results: Of 31 patients, only 56% of LDLc measure­ments were equivalent in the fasting and nonfasting states, compared to 97% of DLDLc ( p < 0.0001), 94% of non-HDLc ( p < 0.001) and 77% of LDLP ( p < 0.01) measurements. Assessment of nonfasting lipid values would have resulted in misclassification by treatment target in 15% of LDLc, 3.2% of DLDLc assessments ( p < 0.05 vs. LDLc), and 0% of non-HDLc and LDLP assess­ments ( p < 0.01 vs. LDLc). Nonfasting LDLc, non-HDLc, LDLP, and DLDLc correctly identified fasting LDLc classification in 23/27 (85%), 26/30 (87%, p = NS vs. nonfasting LDLc), 16/30 (53%, p < 0.001 vs. nonfasting LDLc), and 24/30 (80%, p = NS vs. nonfasting LDLc), respectively.Conclusions: If confirmed in larger studies, nonfasting non-HDLc may be a suitable proxy for fasting LDLc in patients with T2DM.

Shipping fields are being generated on seasonal and monthly bases, in addition to the standard yearly averages. These fields are necessary for computer ambient noise models. However, to use only the set of discrete fields would result in discontinuous behavior of the noise model results as the computer code proceeds from one time interval to the next. To preclude this, an interpolation of the discrete data sets must be done in the time domain. A number of interpolatory functions are considered for either seasonal (4 data points) or monthly (12 data points) periodic fields. Linear, quadratic, and cubic splines were actively investigated. The linear spline does not model seasonal fluctuations in the data well; cubic splines do, and are easy to compute. Linear splines are wholly adequate for monthly fluctuations. [Work supported by ONR.]

To evaluate thoracic periaortic adipose tissue (TAT) burden in patients with type 2 diabetes mellitus (DM) in comparison with controls and in relation to cardiovascular risk factors. A total of 93 patients with type 2 DM (mean (standard deviation; SD) age: 56.7 (11.2) years, 71.0 % were men) and 85 nondiabetic control subjects (mean (SD) age: 54.6 (10.9) years, 58.8 % were men) who were admitted to Mevlana University hospital between January 2011 and June 2013 and underwent multidetector computed tomography for any reason were included in this retrospective cohort study. Patient and control groups were compared in terms of demographic characteristics, anthropometrics, and laboratory findings. TAT volume was evaluated in both groups, while correlates of TAT were determined via linear regression analysis among patients. In patients with type 2 DM, TAT volume (40.1 (23.9) versus 16.9 (7.7) cm(3), p < 0.001), fasting blood glucose (p < 0.001), total cholesterol (p < 0.001), triglyceride (p = 0.017), and low-density lipoprotein (LDL) cholesterol (p = 0.034) levels were significantly higher compared with the control group. Strong positive correlation of TAT was noted with body mass index (r = 0.339, p = 0.001) and serum levels for fasting blood glucose (r = 0.343, p < 0.001), hemoglobin A1c (HbA1c; r = 0.615, p < 0.001), total cholesterol (r = 0.269, p = 0.009), and LDL cholesterol (r = 0.258, p = 0.013). In stepwise regression analysis, Hba1c emerged as a significant predictor of TAT (b = 0.610, p < 0.001), contributing to 19 % of its variability. In conclusion, our findings indicate significantly higher values for TAT in diabetics than controls, being associated positively with body weight, poor glycemic control, and dyslipidemia and strongly predicted by HbA1c levels in diabetic patients, while not differing with respect to gender, smoking status, and concomitant hypertension.

Objective To investigate the correlation of homoeysteine (Hcy) and blood glucose level with type 2 diabetic fundus lesions.Methods Sixty patients with type 2 diabetic fundus lesions were selected and grouped as the diabetic fundus lesions group from February of 2011 to October of 2012,and 40 patients with type 2 diabetes were recruited as the diabetes group,40 healthy volunteer were recruited as the control group.Glycosylated hemoglobin Alc(HbAlc),fasting blood glucose(FBG),homocysteine(Hcy) and total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) of the three groupwere measured and compared.Results Compared with the control group,Hcy in the diabetic fundus lesions group and the diabetic group were significantly higher than the control group ((17.6 ± 4.7) μmol/L,(13.3 ± 2.9) μmol/L vs.(7.3 ± 1.8) μmol/L),and as well as HbA1 c ((11.3 ±2.7)％,(9.2±1.4)％ vs.(4.0±1.1)％),FBG ((11.5 ±3.4) μmol/L,(10.1 ±2.1) μmol/Lvs.(4.2 ±1.7) μmol/L)and TC((6.7 ±1.1) mmol/L,(5.1 ±1.0) mmol/L vs.(4.4±0.8) mmol/L) (F=5.091,5.107,6.017,5.813,P =0.043,0.036,0.032,0.040 respectively).The Hcy,TC,TG,FBG and HbAlc of type 2 diabetic fundus lesions with I stage were the lowest,and the stage of type 2 diabetic fundus lesions was relevant with the level of Hcy,TC,TG,FBG and HbAlc,which were different significantly (F =5.418,5.524,4.971,5.713 respectively,P =0.038,0.041,0.042,0.040 respectively).Conclusion The serum Hcy and blood glucose are risk factors to type 2 diabetic nephropathy.Lowering Hcy concentration and reducing the glucose may be a new way to prevent the occurrence of type 2 diabetic nephropathy. Key words: Type 2 diabetes; Diabetic fundus lesions; Homocysteine; Blood glucose

Energy is one of the indispensible elements of human life and electrical energy is adopted as the most frequently used energy type. As this type of energy can not be stored at the present time, it has to be instantly consumed. In other words, the demand of the consumers has to be compensated, immediately. This paper employs to model the electrical consumption of Erzurum province in 2011 by spline regression and to decide whether a statistically seasonal variation exists for this consumption. The one-year data set of the investigation was obtained from Turkish Electricity Transmission Company Provincial Directorate of Erzurum and was analyzed by the agency of continuous partial polynomial spline regressions. This analysis determined three knots and fits linear, quadratic and cubic spline regression models.

Association between language and risk factor levels among Hispanic adults with hypertension, hypercholesterolemia, or diabetes

Background: Lipid abnormalities are more common in type 2 diabetes mellitus and are aggravated with poor glycaemic control. Lipid abnormalities play an important role in atherosclerosis, a leading cause of mortality in patients with diabetes mellitus. Thus there is a need to evaluate lipid profile and glycemic status in type 2 diabetes mellitus population and determine the major lipid risk factors for coronary artery disease. Present study focuses on the dyslipidemic pattern and glycemic status of male and female with type 2 diabetes mellitus.&#x0D; Methods: Total 270 patients with type 2 diabetes,age 30-60 years, both genderwere included for this crosssectional study which was carried out from January 2019 to December 2019at Bogura Diabetic Hospital, Bogura. A Structured questionnaire was prepared for each study subject after taking informed written consent. Detail personal, medical, family and socioeconomic history of study subjects were collected through history taking and review of clinical and biochemical records from the participants. Diabetic patients were diagnosed depending on history, clinical features and American Diabetes Association(ADA) criteria (2018). Fasting blood glucose, glycatedhaemoglobin (HbA1c)), fasting lipid profile were estimated in all study subjects by standard laboratory methods. Appropriate statistical tests were done.&#x0D; Results: Type 2 male diabetes mellitus participants showed mean fasting blood glucose, HbA1c, total cholesterol, triglyceride and low density lipoprotein cholesterol and high density lipoprotein cholesterol were 8.64 ± 3.38(mmol/L),7.86 ± 2.36(%), 233.09 ± 73.71, 198.19 ± 61.38, 152.98 ± 57.33 and 40.41 ± 5.44 (mg/ dl)respectively. Incase of female patients,fasting blood glucose, HbA1c, total cholesterol, triglyceride and low density lipoprotein cholesterol and high density lipoprotein cholesterol 8.59 ± 3.62(mmol/L),7.88 ± 2.496(%),215.899 ± 83.01, 186.18 ± 67.595, 139.10 ± 65.59 and 40.28 ± 5.66 mg/dlrespectively. There were statistically significant difference (p &lt;0.05) of fasting blood glucose, fasting blood glucose, total cholesterol, triglyceride and low density lipoprotein cholesterol between male and female type 2 diabetic patients.&#x0D; Conclusion: Our study had shown that total cholesterol, triglycerides, and low-density lipoprotein levels were significantly increased in male type 2 diabetes mellitus patients, compared with female type 2 diabetes mellitus patients, while high-density lipoprotein had shown a statistically non-significant difference.This study demonstrated the existence of dyslipidemia in male diabetic population than female which is major risk factor for atherosclerosis and coronary artery disease.&#x0D; Birdem Med J 2021; 11(1): 17-21

Identification and validation of N-acetyltransferase 2 as an insulin sensitivity gene - eScholarship

The incidence of type 2 diabetes mellitus (T2DM) among children and adolescents has been rising. Accumulating evidences have noted the significant role of betatrophin in the regulation of lipid metabolism and glucose homeostasis. In our study, we tried to figure out the underlying mechanism of betatrophin in insulin resistance (IR) in type 2 diabetes mellitus (T2DM). First, fasting serum betatrophin, fasting blood glucose (FBG), insulin, total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were detected in T2DM children. The homeostasis model assessment of insulin resistance (HOMA-IR), Gutt insulin sensitivity index (ISIG) and Matsuda insulin sensitivity index (ISIM) were calculated. A T2DM-IR mouse model was induced by high-fat diet, with the expression of GSK-3β and PGC-1α detected. Besides, HepG2 cells were induced by a high concentration of insulin to establish an IR cell model (HepG2-IR). The cell viability, glucose consumption, liver glycogen content, inflammation, and fluorescence level of GSK-3β and PGC-1α were analyzed. Betatrophin was highly expressed in serum of T2DM children and was positively correlated with FBG, insulin, TC, TG, LDL-C and HOMA-IR, while negatively correlated with ISIG and ISIM. Betatrophin and GSK-3β in the liver tissues of T2DM-IR mice were increased, while the PGC-1α expression was decreased. Betatrophin expression was negatively correlated with PGC-1α and positively correlated with GSK-3β. Silencing of betatrophin enhanced insulin sensitivity through the activation of GSK-3β/PGC-1α signaling pathway. In vitro experiments also found that silencing of betatrophin promoted glucose consumption and glycogen synthesis while inhibited inflammation. Our findings concluded that silencing of betatrophin could enhance insulin sensitivity and improve histopathological morphology through the activation of GSK-3β/PGC-1α signaling pathway.

Objective To investigate the possibility of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) as biomarker for early atherosclerosis in patients with newly diagnosed type 2 diabetes. Methods 420 newly diagnosed type 2 diabetes were enrolled in the study. They were divided into three groups: patients with normal carotid artery were group A (n=152), patients with unilateral carotid plaque were group B (n=138), patients with bilateral carotid plaque were group C (n=130). Their neutrophil, lymphocyte, mean platelet volume, lipid and glucose, carotid intimal medial thickness (CIMT), ankle brachial index (ABI) were all performed in these individuals. Results Compared with group A, the age, systolic pressure, neutrophil count (NC), platelet count (PLT), NLR, PLR, low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), fasting blood glucose (FBG), hemoglobin A1c (HbA1c) and CIMT were higher while ABI were lower in group B and group C; Compared with group B, the age, systolic pressure, NC, PLT, NLR, PLR, LDL-C, TC, CIMT and were higher while ABI was lower in group C (P<0.05). CIMT was positively correlated to age, systolic pressure, NLR, PLR, LDL-C, TC, FBG and HbA1c (P<0.05) while ABI was negtively correlated to age, NLR, PLR, LDL-C, FBG and HbA1c (P<0.05). In multiple linear regression analyses, after adjustment for age, lipid, glucose and so on, NLR and PLR were also significantly correlated to CIMT and ABI. Conclusions NLR and PLR were significantly correlated with CIMT and ABI in newly diagnosed type 2 diabetes. Therefore, NLR and PLR may have the potential to serve as biomarkers for early arteriosclerosis in type 2 diabetic patients. Key words: Diabetes mellitus, type 2/CO/ME; Atherosclerosis/CO/ME; Neutrophils/ME; Lymphocytes/ME; Blood platelets/ME

Objective To explore the relationship between serum osteocalcin levels and glucolipid metabolism in elderly type 2 diabetic patients with non-alcoholic fatty liver disease(NAFLD). Methods Data collected from 97 patients with type 2 diabetes mellitus(T2DM)admitted to the Department of Geriatric Endocrinology of the First Affiliated Hospital of Zhengzhou University from June 2014 to April 2015 were retrospectively analyzed.Patients were divided into the T2DM group(type 2 diabetic patients without NAFLD, n=47)and the NAFLD group(T2DM patients with NAFLD, N=50). Healthy elderly subjects(n=30)from the same period served as the control group.Body mass index(BMI), osteocalcin, fasting blood glucose, fasting insulin, homeostasis model assessment for insulin secretion index(HOMA-β)and insulin resistance(HOMA-IR), glycosylated hemoglobin(HbA1c), total cholesterol, triglyceride, high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)were compared between the 3 groups. Results Levels of fasting blood glucose, fasting insulin, HbA1c, total cholesterol, triglyceride, LDL-C and HOMA-IR were higher, while levels of HDL-C, HOMA-β and osteocalcin were lower in the T2DM and NAFLD groups than in the control group(all P<0.05). Levels of BMI, fasting glucose, fasting insulin, HbA1c, total cholesterol, triglyceride, LDL-C and HOMA-IR were higher and levels of osteocalcin were lower in the T2DM group than in the NAFLD group(all P<0.05). Pearson correlation analysis showed that the osteocalcin level was negatively correlated with fasting blood glucose, HbA1C, HOMA-IR and BMI(r=-0.701, -0.442, -0.337 and -0.543, P<0.05 or P<0.01), and positively correlated with HOMA-β(r=0.341, P<0.05)in the NAFLD group. With serum osteocalcin as the dependent variable, multiple linear regression results showed that fasting blood glucose was an independent influencing factor for serum osteocalcin(β=-1.57, P<0.05)in the fatty liver group. Conclusions Serum osteocalcin levels significantly decrease in elderly T2DM patients with NAFLD, are closely correlated with glucolipid metabolism, and may have some important clinical significance in the prevention and treatment of NAFLD in elderly patients with type 2 diabetes. Key words: Osteocalcin; Diabetes Mellitus, Type 2; Fatty Liver

This study evaluated the effects of methanolic stem bark extract of Cassia sieberiana (MSBECS) on fasting blood glucose (FBG) and serum lipid profile (SLP) of alloxan-induced diabetic albino rats. The extract was prepared by cold maceration and administered orally at the dose of 12.5, 25, 50, 100 and 200 mg/kg body weight to evaluate the effects on fasting blood glucose (FBG) of the diabetic rats, and at 50, 100 and 200 mg/kg body weight (bw) for the serum lipid profile (SLP) assay. A total of 78 male albino rats (Rattus norvegicus) of 12 weeks of age were used for the study; 42 were used to evaluate the effects of the extract on FBG, while 36 were used for the SLP assay. Data from the study showed that the optimum anti-hyperglycemic activity of the C. sieberiana extract on the diabetic rats was recorded in the rat group given 50 mg/kg bw of MSBECS, and this did not differ significantly (p>0.05) from that of glibenclamide-treated rats. Treatment of the diabetic rats with the extract at the doses of 100 and 200 mg/kg bw produced a significant (p<0.05) increase/improvement in the serum high density lipoprotein cholesterol (HDLC), while rat groups given 50, 100 and 200 mg/kg bw of the extract had a significantly (p<0.05) lower serum triglyceride and very low density lipoprotein cholesterol (VLDLC). It was concluded the administration of MSBECS at 50 mg/kg bw led to significant reduction in FBG of diabetic rats comparable to that obtained in the control group treated with a standard anti-hyperglycaemic drug (glibenclamide), while treatment at doses of 50, 100, and 200 mg/kg bw led to favorable effects on the lipid profile of the diabetic rats. These findings validate the traditional use of the stem bark of C. sieberiana in the management of diabetes mellitus and its dyslipidaemia complications.