Assessing interstitial fluid dynamics in type 2 diabetes mellitus and prediabetes cases through diffusion tensor imaging analysis along the perivascular space.

Objective: To explore the correlation between fat and iron accumulation in the liver and pancreas of obese patients with glycemic metabolic indicators, and to analyze the risk factors for glycemic abnormalities in obese patients. Methods: A prospective study enrolled 160 obese patients who visited Xiangya Third Hospital of Central South University from October 2022 to October 2023. The age [M (Q1, Q3)] was 40.8 (29.5, 43.9) years, with 74 males and 86 females. According to the results of the oral glucose tolerance test (OGTT), they were divided into the normal glucose metabolism (NGT) group(n=68), the impaired glucose tolerance (IGR) group(n=37), and the type 2 diabetes mellitus (T2DM) group(n=55). The proton density fat fraction (PDFF) measured by the MRI-based Dixon technique was used to quantitatively assess the fat content in the liver and pancreas, and the R2* value was used to quantify the iron content in the liver and pancreas. Correlation analysis was used to analyze the correlation between fat and iron deposition in the liver and pancreas of obese patients and glucose metabolism indicators. The multivariate logistic regression model was used to analyze the influencing factors of abnormal glucose metabolism in obese patients. Results: The differences in liver PDFF, liver R2*, pancreatic PDFF, and pancreatic R2* among the three groups were all statistically significant (all P<0.05). The pancreatic PDFF in the T2DM group [12.8% (6.9%, 18.5%)] was higher than that in both the NGT group [7.6% (4.7%, 10.3%)] and the IGR group [7.0% (4.1%, 12.0%)] (all P<0.05). The pancreatic R2* in the T2DM group [33.7 (28.3, 39.0)/s] was higher than that in the NGT group [28.6 (26.3, 33.3)/s] and the IGR group [28.5 (25.9, 32.9)/s] (all P<0.05). Significant differences were also observed among the three groups in terms of the homeostatic model assessment of insulin resistance (HOMA-IR), the homeostatic model assessment of β-cell function (HOMA-β), the insulin sensitivity index (ISI), and blood glucose levels at 0, 0.5, and 2.0 h during the oral glucose tolerance test (OGTT) (all P<0.05). The T2DM group had the lowest HOMA-β, while the NGT group had the highest (all P<0.05). Liver PDFF was positively correlated with HOMA-IR and blood glucose levels at 0, 0.5, and 2.0 h during OGTT (all r>0.25) and negatively correlated with ISI (r=-0.54) (all P<0.05). Pancreatic PDFF was negatively correlated with HOMA-β (r=-0.27) and positively correlated with blood glucose levels at 0, 0.5, and 2.0 h during OGTT (all r>0.24) (all P<0.05). Liver R2* was positively correlated with HOMA-IR and blood glucose levels at 0, 0.5, and 2.0 h during OGTT (all r>0.24) and negatively correlated with ISI (r=-0.29) (all P<0.05). Pancreatic R2* was negatively correlated with HOMA-β (r=-0.26) and positively correlated with blood glucose levels at 0, 0.5, and 2.0 h during OGTT (all r>0.21) (all P<0.05). Multivariate logistic regression analysis revealed that liver PDFF≥9.4% (OR=0.044, 95%CI: 1.03-5.76) was a risk factor for abnormal glucose metabolism in obese patients. Conclusions: Fat and iron accumulation in the liver and pancreas of obese patients is closely related to the occurrence of abnormal glucose metabolism. Fat deposition in the liver is a risk factor for abnormal glucose metabolism in obese patients.

Hypomagnesaemia has been reported in type 2 diabetes mellitus (T2DM) and an association of low serum magnesium (Mg) with insulin resistance has been observed. In this cross-sectional study, 65 new T2DM patients and 65 healthy controls were investigated to assess the Mg status and see the association between Mg level and insulin resistance. Oral glucose tolerance test, HbA1c, serum Mg, and fasting insulin were measured and the level of insulin resistance was calculated by using the homeostasis model assessment for insulin resistance (HOMA-IR). Serum Mg level was similar in T2DM and control groups; a higher frequency of hypomagnesemia was observed in the T2DM than control group (26.2% vs. 12.3%) though it was not statistically significant (p= 0.074). Level of insulin resistance (HOMA-IR) was higher in the T2DM group and a higher frequency of subjects had insulin resistance in this group compared to controls. No significant differences in age, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), fasting plasma glucose (FPG), HbA1c, fasting insulin level and HOMA-IR were observed between normomagnesaemic and hypomagnesaemic T2DM subjects. In the T2DM group, age, BMI, WC, WHR, FPG, fasting insulin and HOMA-IR correlated with serum Mg level though in the control group Mg had significant inverse correlations with BMI and fasting insulin. New T2DM subjects and healthy controls had similar Mg status although the frequency of hypomagnesemia was higher (not significant) in the T2DM group and serum Mg level had no correlation with glycemic status, fasting insulin and HOMA-IR in T2DM patients.

The relationship between type 1 diabetes mellitus (T1DM) and periodontal disease may exhibit by the alteration of bone metabolism. However, evidence for this relationship is scarce and inconclusive. Thus, the aims of the present study were to investigate salivary receptor activator of nuclear factor kappa-β (RANK), receptor activator of nuclear factor kappa-β ligand (RANKL), osteoprotegerin (OPG) gene expression and the RANKL:OPG ratio in T1DM and non-T1DM. Secondary objective was to determine the relationships of RANK, RANKL and OPG gene expression to clinical parameters of T1DM and periodontal disease. Twenty patients with T1DM and twenty age-matched non-T1DM were recruited. Clinical periodontal parameters were measured. Total RNA was isolated from non-stimulated saliva, and the relative gene expressions of RANK, RANKL, OPG and RANKL:OPG ratio were determined by quantitative real-time polymerase chain reaction. The T1DM group had significantly higher mean periodontal parameters than the non-T1DM group, while the mean plaque scores of both groups were not significantly different. There was a trend of higher relative gene expression of RANK, RANKL, and the RANKL:OPG ratio and lower expression of OPG in T1DM group but no statistic significant different when compared to non-T1DM. In the T1DM group, RANKL:OPG correlated with the percentage of bleeding sites, whereas RANK, RANKL, and HbA1c levels correlated with pocket depth. Bone metabolisms demonstrating by decreased OPG gene expression and upregulated of RANK, RANKL, RANKL:OPG with higher pocket depth and bleeding in T1DM may play an important role in periodontal destruction in T1DM.

Hypertriglyceridemia (HTG) is an important feature of lipid metabolism abnormality in patients with type 2 diabetes mellitus (T2DM). Apolipoprotein A5 (apoA5) is positively correlated with triglycerides (TG) and insulin resistance (IR). However, its relationship with TG in humans is still controversial till now. Further, its exact mechanism in TG reducing also remains unclear. Meanwhile, adiponectin (APN) can also inhibit TG in humans. Whether there is any association between apoA5 and APN in TG inhibition remains to be explored. This study was taken to investigate the relationships among apoA5, TG, APN and IR in patients with impaired glucose regulation (IGR) and T2DM, the levels of apoA5, TG and APN in the plasma were detected in the current study. Thirty five patients with newly-diagnosed T2DM (T2DM group), 30 patients with IGR (IGR group), and 35 sex- and age-matched normal controls (NGT group) were studied. All the subjects underwent an intravenous glucose tolerance test (IVGTT). Fasting apoA5 and APN were detected by an enzyme linked immunosorbent assay (ELISA). Fasting free fatty acid was measured using colorimetry. Homeostasis model assessment of insulin resistance (HOMA-IR) was made. The plasmic apoA5 and APN levels in the T2DM and IGR groups were lower than that in the NGT group. Furthermore, the levels of apoA5 and APN in the T2DM group were lower than those in IGR group (P < 0.05). ApoA5 was negatively correlated with TG, FFA, 2hFFA, LDL-C, FPG, 2hPG, FINS, HOMA-IR, BMI, and WHR, but positively correlated with APN and HDL-C. The multiple linear regression analysis showed TG, APN, FFA, WHR and HOMA-IR were independent factors of apoA5. Down-regulated apoA5 and APN has a synergistic effect in the process from NGT to IGR and then to T2DM. They can increase FFA expression through participating in the occurrence and development of HTG and IR.

Dysfunction of the glymphatic system in the brain in different stages of altered glucose metabolism and its influencing factors are not well characterized. To investigate the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states, the present study employed diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Sample size was calculated using the pwr package in R software. This cross-sectional study enrolled 22 patients with normal glucose metabolism (NGM), 20 patients with prediabetes, and 22 patients with type 2 diabetes mellitus (T2DM). A 3.0T magnetic resonance imaging was used to evaluate the function of the glymphatic system. The mini-mental state examination (MMSE) was used to assess general cognitive function. The DTI-ALPS index of bilateral basal ganglia and the mean DTI-ALPS index was calculated. Further, the correlation between DTI-ALPS and clinical features was assessed. The left-side, right-side, and mean DTI-ALPS index in the T2DM group were significantly lower than that in the NGM group. The right-side DTI-ALPS and mean DTI-ALPS index in the T2DM group were significantly lower than those in the prediabetes group. DTI-ALPS index lateralization was not observed. The MMSE score in the T2DM group was significantly lower than that in the NGM and prediabetes group. After controlling for sex, the left-side DTI-ALPS and mean DTI-ALPS index in the prediabetes group were positively correlated with 2-hour postprandial blood glucose level; the left-side DTI-ALPS index was negatively correlated with total cholesterol and low-density lipoprotein level. The right-side DTI-ALPS and mean DTI-ALPS index were negatively correlated with the glycosylated hemoglobin level and waist-to-hip ratio in the prediabetes group. The left-side, right-side, and mean DTI-ALPS index in the T2DM group were positively correlated with height. The left-side and mean DTI-ALPS index in the T2DM group were negatively correlated with high-density lipoprotein levels. Cerebral glymphatic system dysfunction may mainly occur in the T2DM stage. Various clinical variables were found to affect the DTI-ALPS index in different glucose metabolism states. This study enhances our understanding of the pathophysiology of diabetic brain damage and provides some potential biological evidence for its early diagnosis.

Subclinical left ventricular (LV) dysfunction is prevalent in type 2 diabetes (T2DM). As obesity has been proposed as one causal factor in the disease process, this could bias the reported prevalences. We wanted to characterize echocardiographic LV dysfunction in obese T2DM subjects as compared to non-diabetic obese controls. One hundred patients with T2DM without clinical signs of heart failure (29% females, mean ± SD age 58.4 ± 10.5 years, body mass index (BMI) 30.1 ± 5.5 kg/m(2), blood pressure (BP) 141 ± 18/83 ± 9 mmHg) and 100 non-diabetic controls (29% females) matched for age (58.6 ± 10.5 years), BMI (29.8 ± 4.0 kg/m(2) and systolic BP (140 ± 14 mmHg) underwent echocardiography and color tissue Doppler imaging (TDI). Diastolic function was evaluated with conventional Doppler recordings and early (e') and late (a') myocardial velocities. The ratio between early transmitral filling (E) and the corresponding myocardial tissue velocity (e') served as an index of LV filling pressure. T2DM patients had more concentric hypertrophy with a relative wall thickness of 0.42 ± 0.07 vs controls 0.38 ± 0.07, P < 0.001. The T2DM group had signs of diastolic dysfunction with lower E/A ratio (0.91 ± 0.27 vs. 1.12 ± 0.38, P < 0.001), deceleration time (195 ± 49 vs 242 ± 72 ms, P < 0.001), e' (5.7 ± 2.0 vs. 6.6 ± 1.8 cm/s, P = 0.001), and a' (6.5 ± 2.0 vs. 7.6 ± 1.5 cm/s, P < 0.001) compared to the controls, and higher E/e' (13.3 ± 4.7 vs. 11.1 ± 3.5, P < 0.001). Thus, there were indications of pseudo normalization and increased filling pressure in the T2DM group, whereas the controls had evidence for relaxation abnormalities without elevated filling pressure. Compared to a non-diabetic obese group, more advanced subclinical impairment of diastolic function was seen in T2DM.

Background: There have been recent reports that the fat distribution within skeletal muscle and the amount of muscle mass are associated with insulin resistance and the development of type 2 diabetes mellitus (T2DM). This study evaluated the impacts of visceral fat and thigh muscle from patients with T2DM and healthy subjects on atherosclerosis and insulin resistance. Methods: Forty-two patients with newly-developed T2DM and 11 healthy subjects were selected for the study. The diabetic patients were subdivided into two groups, those under 40 years of age, as the young T2DM (n=21) group, and 40 years-old or greater, as the old T2DM (n=21) group. CT scans were obtained for all patients at the L4-L5 level and at the mid-portion between the greater trochanter and upper margin patella. The carotid intima-media thickness (IMT) was also measured using high resolution B-mode ultrasonography. Results: The mean visceral fat area (VFA) in the old T2DM group was 169.4 ± 13.2 cm 2 , which was significantly greater than that found in the healthy subjects (67.9 ± 7.92 cm 2 , P < 0.001) and young T2DM group (127.1 ± 10.4 cm 2 , P < 0.05). The mean visceral fat to normal density muscle area ratio (VMNR) in the old T2DM group was 1.50 ± 0.19, which was greater than in the healthy subjects (0.46 ± 0.52, P <0 .001) and young T2DM group (1.01 ± 0.10, P < 0.05). The total thigh muscle areas in the young and old T2DM groups were smaller than that in the healthy subjects, but without statistical significance. VMNR showed a positive correlation with the IMT and HOMA-IR. However, the total thigh muscle area was negatively correlated with the IMT. The normal density muscle area also showed significant negative correlations with the IMT and HOMA-IR. In a multiple regression analysis, age and VMNR were the most important independent risk factors of an increased carotid IMT. Conclusion: This study showed that the role of thigh muscle, as well as that of visceral fat, played a very important role in the occurrence of atherosclerosis. VMNR was found to be an especially important independent factor for an increased carotid IMT (J Kor Soc Endocrinol 20:452～459, 2005).

Carotid intima-media thickness (C-IMT) increases in patients with adult type-2 diabetes mellitus (DM) and is used for early detection of macrovascular complications. We aimed to investigate the change of C-IMT in prediabetes and type-2 DM patients compared to subjects with normal glucose metabolism (NGM).A total of 180 individuals (60 subjects with NGM, 60 patients with prediabetes and 60 patients with type-2 DM) were included in this study. Routine laboratory and micro-macrovascular involvement were investigated. Urine albumin-creatinine ratio (ACR) was measured for urinary albuminuria detection. In addition to routine laboratory examination, right-left common and internal C-IMT (CC-IMT and IC-IMT) were measured.Systolic and diastolic blood pressure values were found to be higher in prediabetes and type-2 DM groups than NGM group. The prevalence of nephropathy and presence of CAD were higher in type-2 DM groups than prediabetes. Glucose, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, blood urea nitrogen, creatinine, high sensitive C reactive protein (hs-CRP) levels and urinary ACR were significantly higher in patients within prediabetes and type-2 DM groups than NGM group. Glucose, HbA1c and hs-CRP levels were found to be higher in type-2 DM groups than prediabetes. Estimated glomerular filtration rate and high-density lipoprotein (HDL) cholesterol level was found to be lower in patients within prediabetes and type-2 DM groups than NGM group. Right-left-mean CC-IMT and IC-IMT values were found to be higher in prediabetes and type-2 DM groups than NGM group. Left IC-IMT, left CC-IMT, and mean IC-IMT values were found to be higher in type-2 DM patients compared to prediabetes. LDL and HDL cholesterols, HbA1c, and hs-CRP levels were independently associated with IC-IMT and CC-IMT.C-IMT values were significantly higher in impaired glucose metabolism compared to NGM. C-IMT measurement may be used as part of routine screening of macrovascular complication in patients with prediabetes and newly diagnosed type-2 DM.

This study utilized artificial intelligence (AI) to quantify coronary computed tomography angiography (CCTA) images, aiming to compare plaque characteristics and CT-derived fractional flow reserve (FFR-CT) in type 2 diabetes mellitus (T2DM) patients with or without hypertension (HTN). A retrospective analysis was conducted on 1,151 patients with suspected coronary artery disease who underwent CCTA at a single center. Patients were grouped into T2DM (n = 133), HTN (n = 442), T2DM (HTN+) (n = 256), and control (n = 320). AI assessed various CCTA parameters, including plaque components, high-risk plaques (HRPs), FFR-CT, severity of coronary stenosis using Coronary Artery Disease Reporting and Data System 2.0 (CAD-RADS 2.0), segment involvement score (SIS), and segment stenosis score (SSS). Statistical analysis compared these parameters among groups. The T2DM (HTN+) group had the highest plaque volume and length, SIS, SSS, and CAD-RADS 2.0 classification. In the T2DM group, 54.0% of the plaque volume was noncalcified and 46.0% was calcified, while in the HTN group, these values were 24.0 and 76.0%, respectively. The T2DM (HTN+) group had more calcified plaques (35.7% noncalcified, 64.3% calcified) than the T2DM group. The average necrotic core volume was 4.25 mm3 in the T2DM group and 5.23 mm3 in the T2DM (HTN+) group, with no significant difference (p > 0.05). HRPs were more prevalent in both T2DM and T2DM (HTN+) compared to HTN and control groups (p < 0.05). The T2DM (HTN+) group had a higher likelihood (26.1%) of FFR-CT ≤0.75 compared to the T2DM group (13.8%). FFR-CT ≤0.75 correlated with CAD-RADS 2.0 (OR = 7.986, 95% CI = 5.466-11.667, cutoff = 3, p < 0.001) and noncalcified plaque volume (OR = 1.006, 95% CI = 1.003-1.009, cutoff = 29.65 mm3, p < 0.001). HRPs were associated with HbA1c levels (OR = 1.631, 95% CI = 1.387-1.918). AI analysis of CCTA identifies patterns in quantitative plaque characteristics and FFR-CT values. Comorbid HTN exacerbates partially calcified plaques, leading to more severe coronary artery stenosis in patients with T2DM. T2DM is associated with partially noncalcified plaques, whereas HTN is linked to partially calcified plaques.

Objective To study the levels of senlm uric acid(UA)in normal glucose(NC),impaired glucose regulation(IGR)and type 2 diabetes mellitus(T2DM),and investigate its relationship with insulin resistance and dyslipidemia.Method The levels of blood glucose,lipids,fasting insulin(HNS)and serum UA were measured in patients of 45 T2DM(T2DM group),20 IGR(IGR group)and 29 NC(NC group).Status of insulin resistance and insulin secretion function was evaluated by HOMA-IR and ISI.Results The levels of triglyceride(TG)and UA in T2DM group and IGR group were significantly higher than those in NC group[(3.34±8.77),(1.85±0.67),(1.26±0.38)mmoi/L and(316.71±96.20),(403.62±76.80),(325.45±94.43)mmol/L](P<0.01).HDL-C levels in T2DM group were significantly lower than those in IGR and NC group[(1.05±0.30),(1.07±0.21),(1.12±0.20)mmol/L](P<0.01).NO significant difference of FINS levels was found in the three groups.HOMA-IR level in T2DM and IGR group was higher than that in NC group(3.84,3.77,2.34)(P<0.01).ISI in T2DM and IGR group was lower than that in NC group(-4.52±0.79,-4.44±0.19,-4.03±0.58)(P<0.01).Correlation analysis indicated that the level of UA was positively related with BMI.TG and negatively related with HDL-C.Conclusion Increased UA in IGR indicates that hyperurieacidemia developes before DM. Key words: Uric acid; Diabetes mellitus; Impaired glucose regulation

Background: Type 2 Diabetes Mellitus (T2DM) is a common problem that is accompanied by disturbed metabolic homeostasis, oxidative stress and increase in proinflammatory cytokines.On the other hand, normal body metabolism is essential for the testicular function.Also, nesfatin-1 is a peptide hormone produced by numerous tissues, including the testes and shared in regulation of metabolic homeostasis and had antioxidant and anti-inflammatory properties.Aim: To investigate the effects of T2DM on testicular functions and the effects of exogenous treatment with nesfatin-1 on modulation of those effects, and, to declare the possible involved mechanisms.Material and Methods: 24-healthy adult male albino rats with a weight of 180-200gm, were divided into three groups of 8 rats each; control, type 2 diabetic (T2DM) and nesfatin-1 treated type 2 diabetic (T2DM + Nesfatin) groups.The control group received a standard diet, while, the diabetic groups (T2DM and T2DM + Nesfatin) received a High Fat Diet (HFD).Five weeks after beginning HFD, rats were fasted for 12h and received streptozotocin, in a dose of 35mg/kg, dissolved in 0. 1M sodium citrate buffer (pH 4.5) intraperitoneally (i.p.).Then, rats of the control and T2DM groups received normal saline i.p. in a dose of 1ml/kg/day for more 4 weeks and they continued to be fed with their corresponding diet, while, those of T2DM + Nesfatin group were treated with nesfatin-1 in a dose of 2 µ g/kg/day i.p. for more 4 weeks and they continued to be fed with HFD.The serum levels of testosterone, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), tumor necrosis factor alpha (TNF α ) and interleukin-1 beta (IL-1 β ) were measured in the studied groups.Also, epididymal sperm motility and count, testicular histopathology and antioxidant enzymes Superoxide Dismutase (SOD) and catalase (CAT) activities were examined.Results: A significant (p<0.001)increase in the final Body Mass Index (BMI), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index, serum levels of glucose, insulin, Total Cholesterol (TC), Triglycerides (TG), Low Density Lipoprotein (LDL), TNFα and IL-1 β was found in the T2DM group in comparison to the control group.On the other hand, a significant (p<0.001)decrease in serum levels of High Density Lipoprotein (HDL), FSH, LH, and testosterone was

BackgroundBetatrophin may increase islet β cell proliferation in insulin resistance and irisin may improve glucose tolerance in mice. To examine the relationship between betatrophin and irisin, we investigated it in middle-aged Chinese subjects with normal glucose tolerance (NGT) and type 2 diabetes mellitus (T2DM).MethodsA total of 460 permanent residents of Fengxian District, aged 40–60 years and without T2DM, were enrolled. Anthropometric parameters, oral glucose tolerance test (OGTT) results, glycosylated haemoglobin levels, blood lipid levels, insulin sensitivity (homeostasis model assessment of insulin resistance, HOMA-IR), β cell function (homeostasis model assessment-β, HOMA-β), estimated glomerular filtration rate (eGFR) and body fat composition were determined. Matched for age, gender and body mass index (BMI, 18–28 kg/m2), newly diagnosed T2DM (n = 50, male/female = 23/27) and NGT (n = 50, male/female = 21/29) subjects were selected based on the results of an OGTT. Serum betatrophin and irisin levels were determined by enzyme linked immune sorbent assay (ELISA).ResultsMales had higher levels of betatrophin compared with females in both the NGT and T2DM groups. Compared with NGT subjects, the level of betatrophin in the T2DM group was higher, and males in the T2DM group had higher betatrophin levels than males in the NGT group, but there was no significant difference in betatrophin levels in females between the T2DM and NGT groups. Spearman’s correlation analysis revealed that serum betatrophin levels in females with NGT were positively correlated with irisin and negatively correlated with FINS (fasting insulin) levels ( p < 0.05), but no correlation was found between betatrophin and irisin levels in males with NGT or in males or females with T2DM. In females with T2DM, circulating betatrophin levels were positively correlated with weight, BMI and hip circumference (p < 0.05) but negatively correlated with FPG (fasting plasma glucose) and HOMA-IR (p < 0.05).ConclusionsGender differences in the relationship between betatrophin and irisin indicate that there might be cytokine-mediated crosstalk among the liver, adipose tissue and skeletal muscle.

Relationship between serum betatrophin levels and the first-phase of glucose-stimulated insulin secretion

Background. Comorbidity profiles are a common subject of research in patients with asthma-COPD (chronic obstructive pulmonary disease) overlap (ACO), but in case of concurrent type 2 diabetes mellitus (T2DM), there is a lack of targeted research on the quality of life, clinical course, and lung function. The aim of the study was to clarify the clinical features of asthma-COPD overlap in combination with T2DM. Materials and methods. Sixty-nine patients were examined: 24 with ACO and T2DM (group 1), 21 with asthma and T2DM (group 2), and 24 with COPD and T2DM (group 3). A diagnosis of ACO was made according to GINA and GOLD 2017 guidelines. Quality of life was assessed using the CAT, ACQ, and SGRQ, and the severity of dyspnea was assessed using the mMRC scale, disease severity and prognosis using the BODE index. Spirometry with bronchodilation test, 6-minute walk test, and bioimpedance analysis were performed. Results. Patients in the main group had a higher total SGRQ score than those in group 3 (by 33 %, p = 0.001). Higher ACQ and total SGRQ scores indicate a trend toward worse asthma control and lower quality of life in patients with ACO and T2DM compared to the asthma + T2DM group (p = 0.056 and p = 0.054, respectively). Body mass index was higher than in patients with COPD and T2DM (by 16.3 %, p = 0.001). Higher serum glucose levels were found in patients with ACO and T2DM than in those with COPD and T2DM (by 18.3 %, p = 0.028). The FEV1 in the ACO and T2DM group was lower than in the asthma + T2DM group (by 18.7 %, p = 0.027), and the SVC was lower by 33 % (p = 0.021). There was a tendency to a lower result in the 6-minute walk test in the main group compared to patients from group 3 (p = 0.0548), and a higher frequency of exacerbations per year compared to groups 2 (p = 0.08) and 3 (p = 0.06). Conclusions. Patients with asthma-COPD overlap and concurrent type 2 diabetes mellitus have worse quality of life, lower FEV1 and SVC, submaximal exercise tolerance, higher fasting glucose levels, and a tendency towards increased exacerbation frequency.

BackgroundGut microbiome has recently been identified as a new potential risk factor in addition to well-known diabetes risk factors. The aim of this study was to analyze the differences in the composition of gut microbiome in prediabetes(PreDM), type 2 diabetes mellitus (T2DM) and non-diabetic controls.MethodsA total of 180 participants were recruited for this study: 60 with T2DM, 60 with PreDM and 60 non-diabetics (control group). Fecal samples were collected from the participants and genomic DNA was extracted. The composition and diversity of gut microbiome were investigated in fecal DNA samples using Illumina sequencing of the V3∼V4 regions of 16sRNA.ResultsThere were significant differences in the number of bacteria among patients with PreDM and T2DM and the control group. Compared with the control group, Proteobacteria bacteria were significantly higher in the PreDM group (P = 0.006). On the genus level, Compared with the control group, the relative abundance of Prevotella and Alloprevotella was significantly higher in the T2DM group (P = 0.016, P = 0.018), and the relative abundance of Paraprevotella in T2DM and PreDM groups was lower than that in the control group (P = 0.011, P = 0.045). Compared with the PreDM group and the control group, the relative abundance of Bacteroides in the T2DM group was significantly lower (P = 0.019, P = 0.002).ConclusionsThe present study found significant differences in the gut microbiome between PreDM, T2DM and non-diabetic individuals, specifically at the genus level, suggesting that early intervention in PreDM patients could have implications for gut flora transitioning to T2DM. In addition, these results may be valuable for developing strategies to control T2DM by modifying the gut microbiome.