Blood Glucose Index Research Articles

RELATIONSHIP BETWEEN BENIGN PROSTATIC HYPERPLASIA AND METABOLIC SYNDROME

Introduction: Factors that may increase the risk of Benign Prostatic Hyperplasia (BPH), and one theory suggests a possible connection between metabolic syndrome and the development of BPH. This study aims to investigate the potential relationship between metabolic syndrome and the development of BPH. Methods: This study analyzed medical records from Saiful Anwar Hospital in Malang from 2015 to 2020, using a case-control research design. It applied Chi-Square and Logistic Regression methods for data analysis. Results: The study, based on data from 90 patients, found that the highest number of BPH cases (75.56%) occurred in those with hypertension. Factors like body mass index and blood pressure were significantly associated with BPH (p-values = 0.046; OR = 2.473). Logistic regression confirmed the impact of fasting blood glucose, blood pressure, and body mass index categories on BPH. Conclusion: This research illustrates that there is an association between type 2 diabetes, hypertension, and obesity with the occurrence of BPH. However, there is no statistically significant relationship between the components of metabolic syndrome and the occurrence of BPH.

The relationship between daily blood glucose fluctuation and readmission in patients with acute coronary syndrome

Abstract Background Although the comprehensive diagnos and treatment of patients with acute coronary syndrome(ACS) has been greatly improved,the morbidity and mortality are still high. Previous literature has reported that about 70-75% of patients diagnosed with acute coronary syndrome have abnormal blood glucose metabolism1,and there existed gender differences. At present, most research results showed that elevated blood glucose is related to the prognosis of ACS. However, further intervention studies indicated that simply strengthen the reducement of blood glucose did not improve prognosis of these patients2. Glucose fluctuations, another dimension of blood glucose, reflect acute changes in blood glucose. However, there are few studies on the effect of blood glucose fluctuation on the prognosis of patients with ACS. Purpose This study aimed to explore the relationship between seven daily fluctuations of blood glucose and readmission in ACS patients. Methods In this study, a total of 664 patients admitted to our University from January 1, 2019 to December 31, 2019 were included and their blood glucose was monitored seven times a day during their hospitalization. The coefficient of variation of blood glucose (CV) was calculated from the results of seven daily blood glucose monitoring to represent the daily fluctuation of blood glucose. Univariate and multivariate regression analyses were performed to determine whether CV was an independent risk factor for re-hospitalization. In addition, the area under the curve (AUC) was used to evaluate the predictive efficacy of CV for outcome events. Finally, we performed a subgroup analysis based on gender and diabetes status to assess the association between CV and readmission in each subgroup. Results After a median follow-up of 21 months, the rate of readmission was 38.4%. Unstable angina pectoris (71.4%) and heart failure (16.4%) were the most common reasons for readmission. Patients with greater CV levels typically exhibited lower fasting blood glucose, higher post breakfast blood glucose, and higher admission blood glucose.The readmission rate increased with the increasing blood glucose variability after the cox regression analysis. Moreover, independent of glycated hemoglobin,CV could predict the risk of readmission in patients with ACS.When using 26.66% as the cutoff point of CV, the study population was divided into two groups and showed a significant differentiation for rehospitalization.In subgroup analysis, there was no significant association between seven daily blood glucose fluctuations and readmission in female and non-diabetes mellitus patients with acute coronary syndrome. Conclusions Besides some normal blood glucose index,seven daily fluctuations of blood glucose was associated with readmission in ACS patients. ACS patients who were male and combined with diabetes were more likely to be readmitted if their CV levels were greater.

Potential Impacts of Dried Green Coleus forskolin Leaves on Thermo-tolerance Parameters, Blood and Plasma Profiles in Anesthetized Mice

Background: Transient negative side effects of hypothermia, hyperglycemiaand bradycardia due to general anesthesia using diazepam and xylazine drugs has been reported in mice. Methods: Twenty albino male mice of 31.52±0.25 g body weight were classified into two groups; control group (G1) fed basal control diet versus C. forskolin group fed basal control diet containing C. forskolin leaves (G2; 1.5%) for four weeks. The mice were general anesthetized using xylazine and diazepam (XD) drugs (13.3 mg/kg BW diazepam and 26.6 mg/kg BW xylazine). Changes of rectal temperature (°C), glucose (mg/dl), pulse rate (pulse/min.) and partial pressure of oxygen (SPO2) were recorded at 0.0, 0.5h, 1.0h, 2.0h, 3.0h, 5.0h and 7.0h over general anesthesia. In addition, blood samples were collected and were subjected to blood and plasma analyses. Result: The results indicated that dietary C. forskolin caused significant decrease (P less than 0.05) in glucose values in addition to significant increase (P less than 0.05) in rectal temperature, pulse rate and SPO2 during the period hypothermia, hyperglycemiaand bradycardia over general anesthesia. In addition, values of blood (RBCs, WBCs, PCV and Hb) and plasma parameters (TP, BUN, creatinine, AST and ALT, LDH) were normal due to C. forskolin supplementation compared to control diet. It could be concluded that 1.5% C. forskolin supplementation modulates thermo-tolerance responses, blood glucose indices, blood and plasma metabolites over general anesthesia.

Can a mobile application improve glucose-related and patient-reported outcome measures (PROMs) in people with type 1 diabetes mellitus? A randomized controlled trial using the mySugr® app.

Mobile applications (apps) have proven to be highly effective tools to empower patients with type 1 diabetes mellitus (T1DM) and enable them to achieve better self-care, quality of life (QOL), and glycemic control. The aim of the study is to examine whether mySugr®, an app for diabetes management, together with teleconsultations, can have a positive impact on these factors and, thereby, replace current clinical care. This study concerns an exploratory randomized clinical trial of 12 months' duration. People with T1DM using multiple daily injections were randomized to usual care (bolus calculator, five face-to-face visits) or intervention (mySugr® app, three face-to-face visits, and two teleconsultations). The main outcome was increase in empowerment assessed with the Diabetes Empowerment Scale Short Form questionnaire (DES-SF-S). Secondary outcomes were change in additional glucose-related (blood glucose monitoring, mean blood glucose, standard deviation, coefficient of variation (CV), and high and low blood glucose index) and patient-reported outcome measures (PROMs) (self-management, QOL, and distress). A total of 25 out of 28 participants completed the study (52% men, age 44.52 years, diabetes duration 21.28 years). At 12 months, no significant differences were identified in the change of DES-SF-S and additional PROMs between arms. Similarly, no differences were observed in glucose-related outcomes except for the change in CV at 9 (control - 1.87 ± 4.98 vs. intervention 5.89 ± 11.33, p = 0.008) and 12 months (control - 2.33 ± 3.54 vs. intervention 5.12 ± 11.32, p = 0.018). Adherence to and satisfaction with the app were high. Patients with diabetes using the mySugr® app and teleconsultation achieved similar results to those following usual care in empowerment, other PROMs, and most glucose-related outcomes, thus supporting its use in combination with face-to-face visits. The RCT was registered with ClinicalTrials.gov (NCT03819335, first registration 28/01/2019).

Non-Pharmacological Management of Gestational Diabetes Mellitus with a High Fasting Glycemic Parameter: A Hospital-Based Study in Vietnam

Background/Objectives: The prevalence of gestational diabetes mellitus (GDM) is increasing at an alarming rate worldwide. Delayed management can lead to adverse composite outcomes for both mother and her offspring. To our knowledge, the clinical association between glycemic parameters and the results of the non-pharmacological GDM approach remains limited; thus, this study aimed to address this important clinical issue in the literature. Methods: This was a retrospective cross-sectional study of 174 Vietnamese pregnant women with the positive oral glucose tolerance test (OGTT) for a high fasting glycemic parameter at Hung Vuong Hospital from 04/2022 to 07/2022. This study aimed to evaluate the success rate of GDM with an elevated index of fasting glycemic concentration which was managed after 2 weeks of a dietary regimen combined with adequate physical activities and to reveal its related factors. Results: Out of 174 singleton pregnancies that met the inclusion criteria, 103 GDM pregnant women were successfully managed after 2 weeks of monitoring (59.2%; 95% confidence intervals (CI): 51.9–66.5). The study revealed a fair correlation between the corresponding test of blood glucose at OGTT and after 2 weeks of GDM management (r = 0.270–0.290, p < 0.0001). The GDM pregnant women with an elevated fasting glycemic parameter and with any of elevated 1 h or 2 h blood glucose levels and in cases of three elevated glycemic parameters (fasting, 1 h, and 2 h blood glucose at the initial results of OGTT) reduced the success rate of glycemic control to 56.5%, 49.2%, respectively, compared to the group with solely a high fasting index of blood glucose (69.6%). The pregnant women who participated in high-intensity sports activities related to a two-fold increase in success rate compared with the group engaging in light and moderate-intensity physical activity. Conclusions: The success rate of glycemic control in GDM women was highest in the group with solitary fasting hyperglycemia and lower in the contributory groups with two and three high parameters. The application of diet therapy plus physical activities among GDM pregnant women is potentially necessary to improve the effectiveness of treatment, minimize adverse pregnancy outcomes, and reduce substantially the hospitalization rate.

Correlation between prognosis and peripheral blood levels of NLRP3 and triglyceride-glucose index after myocardial ischemia-reperfusion injury

ObjectiveWe aim to investigate the association between prognosis and outcomes following myocardial ischemia-reperfusion injury, as well as peripheral blood levels of NLRP3 and the triglyceride-glucose index (TyG).MethodsA total of 100 patients who underwent emergency coronary intervention following myocardial infarction confirmed by coronary angiography at our hospital between October 2021 and May 2023 were included in this study. Patients were stratified into two groups based on their prognoses: the control group (n = 73), which did not experience new myocardial infarctions or require hospitalization for heart failure or suffer sudden cardiac death post-interventional treatment; and the observation group (n = 27), which experienced one or more cardiovascular events post-treatment. Patient demographics were obtained from clinical records while biochemical analyses assessed peripheral blood triglycerides, blood glucose levels, and TyG index. Additionally, ELISA measurements determined levels of NLRP3 as well as inflammatory factors IL-6, TNF-α, and CRP in peripheral blood samples. Cardiac function was evaluated according to NYHA standards. Univariable Cox regression analysis identified factors influencing patient prognosis while Pearson correlation analysis examined relationships among prognosis, outcomes following myocardial ischemia-reperfusion injury, TyG index, and peripheral blood NLRP3.ResultsNo significant differences were observed in the general characteristics between the two patient groups (P > 0.05). However, the observation group exhibited higher levels of peripheral blood triglycerides, blood glucose, and TyG index compared to the control group (P < 0.05). Additionally, levels of NLRP3 and inflammatory factors IL-6, TNF-α, and CRP were elevated in the observation group compared to the control group (P < 0.05). Cardiac function impairment was more pronounced in the observation group (P < 0.05). Notably, TyG index and peripheral blood NLRP3 demonstrated higher risk ratios compared to other biomarkers (P < 0.05), indicating their significance in prognosis and outcomes. Elevated levels of NLRP3 and TyG index were associated with poorer recovery of cardiac function, increased rehospitalization rates, and higher mortality (P < 0.05).ConclusionElevated NLRP3 levels and an increased TyG index are strongly associated with impaired cardiac function and heightened risk of cardiovascular events. These findings suggest that these biomarkers may serve as crucial prognostic indicators following myocardial ischemia-reperfusion injury.

Renal protective effect of Isaria felina mycelium powder on diet and STZ-induced diabetes mice and the identification of major chemical constituents

Type 2 diabetes is a group of metabolic diseases mainly characterized by chronic hyperglycemia. Diabetic kidney disease is the most common microvascular complication of diabetes.The aim of this study was to investigate the therapeutic effect of Isaria felina mycelium powder (IFMP) on diet and streptozotocin (STZ)-induced diabetic mouse model. And we analyze the main chemical constituents of Isaria felina mycelium powder.The main chemical constituents of the alcohol-soluble IFMP were prepared and identified by high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF-MS). The fasting blood glucose and renal index of the mouse model was determined. Serum levels of triglyceride (TG), total cholesterol (TC), serum creatinine (Scr) and blood urea nitrogen (BUN) were detected. The levels of CD2AP and nephrin proteins in the kidney were detected by ELISA kits.A total of 32 compounds were identified, including nucleosides (16 types), amino acids (13 types), sterols (one type) and glycosides (two types). The experimental results showed that compared with the diabetes model group, IFMP reduced fasting blood glucose, food intake and water intake. Biochemical analysis indicated that IFMP reduced the serum levels of TG, TC, BUN and Scr, and increased the levels of CD2AP and nephrin proteins in the kidneys.Therefore, IFMP has the potential to treat diabetes and prevent kidney damage induced by hyperglycemia.

Clinical value of multiparameteric quantitative ultrasound for assessing high-risk steatohepatitis

Objective: To investigate the clinical value of multiparameteric quantitative ultrasound combined with a non-invasive prediction model for assessing high-risk steatohepatitis. Methods: One hundred and ninety-four cases with metabolic-associated fatty liver disease (MAFLD) who underwent liver biopsy in Huashan Hospital, Fudan University, from June 2021 to September 2022 were selected. Shear wave elastography (SWE), shear wave dispersion (SWD) imaging, and attenuation imaging (ATI) examinations were conducted in all patients before biopsy. High-risk steatohepatitis was defined as a total activity score of ≥4 in patients with steatohepatitis, hepatocellular ballooning, and liver lobular inflammation based on pathological hepatic steatosis, inflammatory activity, and fibrosis scoring system (SAF), and fibrosis stage≥F2. Binary logistic regression analysis was used to identify the factors influencing high-risk steatohepatitis. A predictive model for diagnosing high-risk steatohepatitis was constructed using R language. The DeLong test was used to compare the area under the curve between groups. Measurement data was compared between groups using the t-test or rank-sum test, and count data were compared between groups using the χ2 test. Results: There were 46 cases (23.7%) with high-risk steatohepatitis. The quantitative ultrasound parameters included elastic modulus (OR=2.958, 95%CI: 1.889-4.883, P<0.001), dispersion coefficient (OR=1.786, 95%CI: 1.424-2.292, P<0.001) and attenuation coefficient (OR=42.642, 95%CI: 3.463-640.451, P=0.004). Serological indexes of fasting blood glucose (OR=1.196, 95%CI: 1.048-1.392, P=0.011), alanine aminotransferase (OR=1.012, 95%CI: 1.006-1.019, P<0.001), aspartate aminotransferase (OR=1.027, 95%CI: 1.014-1.042, P<0.001), γ-glutamyl transferase (OR=1.008, 95%CI: 1.001-1.017, P=0.041) and HDL cholesterol (OR=0.087, 95%CI: 0.016-0.404, P=0.003) were the factors influencing its progression. The AUCs of elastic modulus, dispersion coefficient, attenuation coefficient, multiparametric ultrasound model, serological index model, and ultrasound combined with serology model for the diagnosis of high-risk steatohepatitis were 0.764, 0.758, 0.634, 0.786, 0.773 and 0.825, respectively. The results of the DeLong test showed that the ultrasound combined with the serological model was significantly better than the serological index model and the elastic modulus, dispersion coefficient, and attenuation coefficient alone (P=0.024, 0.027, 0.038 and <0.001). Conclusion: The combination of multiparametric quantitative ultrasound is helpful for the non-invasive diagnosis of high-risk steatohepatitis and possesses great clinical significance.

Empagliflozin add‐on therapy is superior to metformin monotherapy in diabetic patients with NAFLD: An open‐label, single‐center, pilot clinical trial

AbstractBackgroundThe prevalence of non‐alcoholic fatty liver disease (NAFLD), which is characterized by hepatic steatosis, inflammation, and advanced fibrosis, is high among type‐2 diabetes mellitus (T2DM) patients. Empagliflozin (EMPA), a sodium‐glucose cotransporter‐2 inhibitor, has been well established to improve glycemic status in T2DM. However, evidence of the desirable effects of EMPA, when added to the standard treatment in diabetics with coexisting NAFLD, has yet to be determined.ObjectiveThe main objective of the current study is to explore the benefits of EMPA on hepatic fat content in patients with T2DM and NAFLD, who received metformin (MET) monotherapy.MethodsIn this open‐label clinical trial study, 60 patients with T2DM and NAFLD were assigned to either the MET + EMPA or MET group in an up‐titrated manner for 24 weeks. Anthropometric characteristics, blood glucose indices, lipid profile, liver enzymes, and steatosis grades were measured at baseline and 24 weeks after the intervention.ResultsThe results showed that in patients with a mean age of 53.26 ± 7.64 who received MET+ EMPA, all the parameters had a greater decrease than the MET group. In addition, the reduction of FBS, BS, HbA1C, TG, and ALT had a statistically significant difference between the two groups after 24 weeks follow‐up (p &lt; 0.05). Notably, in the MET+ EMPA group, there was a substantial improvement in steatosis grades based on the fibroscan and ultrasound modality results.ConclusionThe EMPA add‐on therapeutic schedule in uncontrolled T2DM patients with NAFLD significantly ameliorated steatosis stages, liver function, anthropometric features, and biochemical parameters.

Exploring the relationship between lipid metabolism and cognition in individuals living with stable-phase Schizophrenia: a small cross-sectional study using Olink proteomics analysis

BackgroundCognitive impairment is a core symptom of schizophrenia. Metabolic abnormalities impact cognition, and although the influence of blood lipids on cognition has been documented, it remains unclear. We conducted a small cross-sectional study to investigate the relationship between blood lipids and cognition in patients with stable-phase schizophrenia. Using Olink proteomics, we explored the potential mechanisms through which blood lipids might affect cognition from an inflammatory perspective.MethodsA total of 107 patients with stable-phase schizophrenia and cognitive impairment were strictly included. Comprehensive data collection included basic patient information, blood glucose, blood lipids, and body mass index. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and the MATRICS Consensus Cognitive Battery (MCCB). After controlling for confounding factors, we identified differential metabolic indicators between patients with mild and severe cognitive impairment and conducted correlation and regression analyses. Furthermore, we matched two small sample groups of patients with lipid metabolism abnormalities and used Olink proteomics to analyze inflammation-related differential proteins, aiming to further explore the association between lipid metabolism abnormalities and cognition.ResultsThe proportion of patients with severe cognitive impairment (SCI) was 34.58%. Compared to patients with mild cognitive impairment (MCI), those with SCI performed worse in the Attention/Alertness (t = 2.668, p = 0.009) and Working Memory (t = 2.496, p = 0.014) cognitive dimensions. Blood lipid metabolism indicators were correlated with cognitive function, specifically showing that higher levels of TG (r = -0.447, p < 0.001), TC (r = -0.307, p = 0.002), and LDL-C (r = -0.607, p < 0.001) were associated with poorer overall cognitive function. Further regression analysis indicated that TG (OR = 5.578, P = 0.003) and LDL-C (OR = 5.425, P = 0.001) may be risk factors for exacerbating cognitive impairment in individuals with stable-phase schizophrenia. Proteomics analysis revealed that, compared to individuals with stable-phase schizophrenia and normal lipid metabolism, those with hyperlipidemia had elevated levels of 10 inflammatory proteins and decreased levels of 2 inflammatory proteins in plasma, with these changes correlating with cognitive function. The differential proteins were primarily involved in pathways such as cytokine-cytokine receptor interaction, chemokine signaling pathway, and IL-17 signaling pathway.ConclusionBlood lipids are associated with cognitive function in individuals with stable-phase schizophrenia, with higher levels of TG, TC, and LDL-C correlating with poorer overall cognitive performance. TG and LDL-C may be risk factors for exacerbating cognitive impairment in these patients. From an inflammatory perspective, lipid metabolism abnormalities might influence cognition by activating or downregulating related proteins, or through pathways such as cytokine-cytokine receptor interaction, chemokine signaling pathway, and IL-17 signaling pathway.

Assessment of Correlation Between Glycaemic Variability Indices and Measures of Hypoglycaemia in Patients with Type 2 Diabetes Mellitus

Abstract Introduction: Diabetes mellitus is a global health burden, and India is regarded as the diabetes capital of the world. Glycaemic variability (GV) is an established risk factor for hypoglycaemia (plasma glucose concentration &lt;70 mg/dL) and a notorious risk factor for diabetes complications. The primary aim of the study was to assess the correlation between the GV indices, HbA1c levels, and measures of hypoglycaemia in patients with type 2 DM (T2DM). Methods: In this cross-sectional study, continuous glucose monitoring (CGM) was done for a period of 14 days in T2DM patients (n = 50). The GV indices were determined from the readings obtained from the CGM monitor. Spearman’s rank correlation coefficient was used for correlation analyses. The area under the receiver operating characteristics (ROC) curve was used to assess the effectiveness of the various GV indices in predicting hypoglycaemia. Results: A total of 50 T2DM patients had a mean (SD) age of 61.84 ± 11.88 years. Among the GV indices, high blood glucose index (HBGI), average daily risk range (ADRR), and continuous overall net glycaemic action (CONGA) had a significantly positive correlation with HbA1c levels. Average episodes of nocturnal hypoglycaemia in 8 hours of night-time had a statistically significant negative correlation with the HbA1c levels (correlation coefficient: −0.301, P = 0.034). In addition, low blood glucose index (LBGI) was found to be the best predictor for the risk of hypoglycaemia in 24 hours and nocturnal hypoglycaemia. Conclusion: Various GV indices are associated with HbA1c levels and are better predictors of hypoglycaemia.

The Association Between Triglyceride Glucose-Body Mass Index and Kidney Impairment in Patients with Type 2 Diabetes Mellitus.

Insulin resistance is associated with kidney impairment in patients with type 2 diabetes mellitus (T2DM). The triglyceride glucose-body mass index (TyG-BMI), which combines the TyG index with body mass index (BMI), has received significant attention as a tool for evaluating insulin resistance. Thus, the aim of this study was to explore the association between TyG-BMI and kidney impairment in patients with type 2 diabetes mellitus (T2DM). The cross-sectional analysis included 1080 patients with T2DM, and data were collected retrospectively. TyG-BMI was calculated by fasting blood glucose, triglyceride, and body mass index. TyG-BMI was significantly higher in T2DM patients with albuminuria than those without albuminuria (232.16 [206.52-268.02] vs 229.83 [206.11-255.64], p =0.023). T2DM patients with chronic kidney disease (CKD) showed a significantly higher value of TyG-BMI compared with those without CKD (232.23 [206.46-268.28] vs 229.73 [206.11-255.49], p=0.014). Correlation analysis showed a significantly positive association between TyG-BMI and metabolic parameters including BMI (r = 0.866, p < 0.001), TG (r = 0.630, p < 0.001), TC (r = 0.119, p < 0.001), HDL-C (r = -0.374, p < 0.001), FBG (r = 0.297, p < 0.001), and HbA1c (r = 0.116, p < 0.001) in patients with T2DM. The binary logistic regression analysis found that TyG-BMI was an independent factor for albuminuria (OR = 1.004, 95% CI: 1.001-1.008, p = 0.010) and CKD (OR = 1.005, 95% CI: 1.001-1.008, p = 0.005) in patients with T2DM respectively. The study suggests that TyG-BMI is associated with kidney impairment in patients with T2DM. Given that TyG-BMI is a novel parameter of insulin resistance, the study results indicates that clinicians should pay close attention to screening for kidney impairment in T2DM patients with insulin resistance.

Value of Glycemic Indices for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: A Retrospective Single-Center Study.

Delayed cerebral ischemia (DCI) is a severe complication following aneurysmal subarachnoid hemorrhage (aSAH), linked to poor functional outcomes and prolonged intensive care unit (ICU) stays. Timely DCI diagnosis is crucial but remains challenging. Dysregulated blood glucose, commonly observed after aSAH, may impair the constant glucose supply that is vital for brain function, potentially contributing to DCI. This study aimed to assess whether glucose indices could help identify at-risk patients and improve DCI detection. This retrospective, single-center observational study examined 151 aSAH patients between 2016 and 2019. Additionally, 70 of these (46.4%) developed DCI and 81 did not (no-DCI). To determine the value of glycemic indices for DCI, they were analyzed separately in patients in the period before (pre-DCI) and after DCI (post-DCI). The time-weighted average glucose (TWAG, p = 0.024), mean blood glucose (p = 0.033), and novel time-unified dysglycemic rate (TUDR140, calculated as the ratio of dysglycemic to total periods within a glucose target range of 70-140 mg/dL, p = 0.042), showed significantly higher values in the pre-DCI period of the DCI group than in the no-DCI group. In the time-series analysis, significant increases in TWAG and TUDR140 were observed at the DCI onset. In conclusion, DCI patients showed elevated blood glucose levels before and a further increase at the DCI onset. Prospective studies are needed to confirm these findings, as this retrospective, single-center study cannot completely exclude confounders and limitations. In the future blood glucose indices might become valuable parameters in multiparametric models to identify patients at risk and detect DCI onset earlier.

Impact of a ketogenic diet on intestinal microbiota, cardiometabolic, and glycemic control parameters in patients with Type 2 diabetes mellitus.

Abstract. A ketogenic diet (KD), characterized by high fat and low carbo-hydrate intake, has been proposed as a therapeutic option for Type 2 Diabetes Mellitus (T2DM). One hundred individuals with T2DM were selected and divid-ed into a control group (CG) and an observation (OG) group, with 50 patients in each group, to investigate the effects of a KD on the intestinal flora, Gluca-gon Like Peptide-1 (GLP-1), and HbA1c levels in T2DM patients. Individuals in the CG were given standard treatment and diet, while patients in the OG were given a KD based on the CG. The blood glucose index, blood lipid index, HbA1c, GLP-1 levels, physical examination, and intestinal flora were compared in both groups. The FPG, HbA1c, two h PG, HOMA-IR TG, TC, and LDL -C levels in the two groups were reduced when compared to those before treatment (p&lt;0.05), and the decreases in the OG were more significant than in the CG (p&lt;0.05), while the levels of GLP-1 in the two groups were increased compared to those before treatment, those in the OG were significantly increased when compared to the CG (p&lt;0.05). After treatment, waist circumference, BMI, body mass, and the levels of Enterococcus faecalis (E. faecalis) and Escherichia coli (E. coli) of the two groups were reduced compared to indicators before treatment (p&lt;0.05), and those in the OG were even lower than those in the CG (p&lt;0.05). In conclusion, these findings underscore the KD’s potential to act as an effica-cious dietary strategy in managing T2DM.

Dietary fiber of jicama (Pachyrhizus erosus L., Fabaceae) tuber ameliorates kidney structure and function in mice fed with high-sucrose drink

Frequent consumption of high-sugar drinks (HSD) including sugar-sweetened beverages has been associated with the development of kidney disease. Otherwise, proper intake of dietary fiber extracted from the tuber of jicama (Pachyrhizus erosus L., Fabaceae) is shown to exert counteractive effects against HSD-induced metabolic syndrome including diabetes. However, it remains unelucidated whether the incorporation of jicama fiber in the diet could exert a beneficial effect on kidney function. This study aimed to elucidate the protective effect of jicama fiber in the diet against kidney disease caused by HSD. A total of thirty adult male albino mice were randomly assigned into three groups, the control group (fed with distilled water drink and standard diet), the high-sucrose drink group (HSD; fed with 30% sucrose solution drink and standard diet), and the high-sucrose drink + JF group (HSD + JF; fed with 30% sucrose drink and a standard diet supplemented with 25% of jicama fiber). The treatments were performed for ten weeks followed by the measurements of fasting blood glucose, plasma creatinine and kidney indices including urine protein, urine specific gravity, and refractive index and the examination of histopathological alterations in the kidney. The results demonstrated that the incorporation of JF in the diet at the dose of 25% could effectively counteract the elevation of fasting blood glucose and indicators of kidney damage including plasma creatinine, urine protein, urine specific gravity, and urine refractive index caused by HSD. However, JF failed to prevent HSD-induced mass reduction of the kidney but could ameliorate histopathological alterations in the kidney. Furthermore, JF effectively prevented tubular atrophy and fibrosis in the kidney in HSD-treated mice. Therefore, supplementation of the diet with JF at the dose of 25% could be effective in protecting the kidney against HSD. Thus, proper consumption of dietary fiber of jicama tuber has the potential to reduce HSD-induced kidney disease.

Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0–3: a nationwide prospective cohort study

BackgroundThe American Heart Association (AHA) has recently introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, which is the result of an increasing emphasis on the interplay of metabolic, renal and cardiovascular diseases (CVD). Furthermore, there is substantial evidence of a correlation between the triglyceride glucose-body mass index (TyG-BMI ) and CVD as an assessment of insulin resistance (IR). However, it remains unknown whether this correlation exists in population with CKM syndrome.MethodsAll data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The exposure was the participants’ TyG-BMI at baseline, which was calculated using a combination of triglycerides (TG), fasting blood glucose (FBG) and body mass index (BMI). The primary outcome was CVD, which were determined by the use of a standardised questionnaire during follow-up. To examine the relationship between TyG-BMI and CVD incidence in population with CKM syndrome, both Cox regression analyses and restricted cubic spline (RCS) regression analyses were performed.ResultsA total of 7376 participants were included in the final analysis. Of these, 1139, 1515, 1839, and 2883 were in CKM syndrome stages 0, 1, 2, and 3, respectively, at baseline. The gender distribution was 52.62% female, and the mean age was 59.17 ± 9.28 (years). The results of the fully adjusted COX regression analyses indicated that there was a 6.5% increase in the risk of developing CVD for each 10-unit increase in TyG-BMI,95% confidence interval (CI):1.041–1.090. The RCS regression analyses demonstrated a positive linear association between TyG-BMI and the incidence of CVD in the CKM syndrome population (P for overall < 0.001, P for nonlinear = 0.355).ConclusionsThis cohort study demonstrated a positive linear association between TyG-BMI index and increased CVD incidence in a population with CKM syndrome stage 0–3. This finding suggests that enhanced assessment of TyG-BMI index may provide a more convenient and effective tool for individuals at risk for CVD in CKM syndrome stage 0–3.

Effect of a Nurse-Led Exercise Program on Depression in Elderly Patients with Diabetes: A Retrospective Study.

Patients with diabetes often face psychological challenges, particularly depression. The coexistence of these two conditions can significantly impact both the mental and physical health of individuals. This study aims to investigate the effects of nurse-led exercise training on elderly patients diagnosed with type 2 diabetes mellitus and comorbid depression through experimental research. By selecting appropriate exercise programs for patients, the study seeks to identify effective strategies for improving both their physical health and depressive symptoms. Additionally, it aims to offer tailored exercise recommendations to enhance the overall well-being of these patients. The observation group (n = 53) and the control group (n = 53) were selected based on the interventions documented in the patients' medical records, with eligible patients identified as research participants. The control group received standard medication, while the observation group engaged in intensive exercise training in addition to their standard treatment, dedicating 60-90 min per day to exercise. Prior to and following the intervention, blood glucose indices, levels of 5-hydroxytryptamine (5-HT) and norepinephrine (NE), self-rating depression scale (SDS), Self-Rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), and Generic Quality of Life Inventory (GQOLI-74) scores were assessed to evaluate the impact of the exercise training intervention. Following the intervention, levels of fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and Hemoglobin A1c (HbA1c) were reduced compared to pre-intervention levels, with the exercise group exhibiting lower levels than the control group (p < 0.05). Additionally, post-intervention, patients' levels of 5-HT and NE increased, with the exercise group demonstrating higher levels than the control group (p < 0.05). Moreover, post-intervention, SDS and SAS scores decreased, with more significant improvements observed in the observation group (p < 0.05). Furthermore, the intervention improved sleep quality and quality of life among patients in the exercise group compared to those in the control group (p < 0.05). Nurse-guided exercise training demonstrates a significant capacity to ameliorate glycemic indexes among patients with diabetes mellitus comorbid with depression. It not only diminishes depression and anxiety levels but also enhances the expression of 5-HT and NE. Furthermore, it effectively elevates patients' sleep quality and quality of life. These findings underscore the potential of nurse-led exercise interventions for clinical promotion and widespread application.

Hepatic insulin resistance affects the efficacy of metformin in patients with newly diagnosed type 2 diabetes: A Sub-Analysis of the MARCH trial

AimOur study aimed to analyze how hepatic insulin resistance (IR) influences the efficacy of 48 weeks of metformin treatment in newly diagnosed type 2 diabetes patients. MethodsWe chose 291 participants who were allocated to a 48-week metformin treatment in the “Metformin and Acarbose in Chinese as initial Hypoglycemic treatment” (MARCH) trial and calculated their hepatic insulin resistance indexes (HIRI). We equally grouped the subjects into tertiles: low, medium, and high HIRI groups based on baseline HIRI; Low, medium, and high ΔHIRI groups based on the decreasing extent of HIRI after a 48-week metformin treatment. ResultsMultiple linear regression showed that baseline HIRI was positively associated with the rising degree of Matsuda index and the falling range of fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and HIRI. Furthermore, baseline fasting insulin, homeostatic model assessment of β cell function (HOMA-β), HOMA-IR, and HIRI were positively associated with the decreasing extent of HIRI, while baseline Matsuda index had a negative association with the falling extent of HIRI. ConclusionsPatients with higher levels of hepatic IR obtained better curative effects from metformin in terms of glycemic control, insulin saving, insulin sensitivity enhancement, and IR improvement. Higher fasting blood glucose, fasting insulin, HOMA-β, IR, and lower Matsuda index were indicators of better hepatic IR improvement.

Effects of adding blueberry residue powder and extrusion processing on microstructure and in vitro digestibility of indica rice flour

Using crushed indica rice flour as the main raw material, after adding blueberry residue powder, the indica rice puffed powder containing blueberry residue (IREPBR) was obtained through extrusion and crushing. The effects of adding blueberry residue and extrusion processing on the microstructure and in vitro digestibility of indica rice flour were studied. The basic component analysis results showed that the fat and total starch content of indica rice powder significantly decreased after adding blueberry residue powder and extrusion puffing, while the total dietary fiber content significantly increased. The results of scanning electron microscope (SEM) showed that there were many pits and bubbles in the extruded indica rice flour after adding blueberry residue powder. Compared with indica rice flour (IRF), its Water Absorption Index (WAI) and Water Solubility Index (WSI) significantly increased, and its thermal properties also changed. XRD and FT-IR analysis showed that after extrusion, the crystalline morphology of indica rice starch changed from A-type to V-type, and the relative crystallinity also changed. In addition, the content of resistant starch (RS) in indica rice flour added with blueberry residue powder and processed by extrusion increased significantly, while the starch hydrolysis rate and estimated blood glucose index (eGI) decreased.

Life’s Essential 8 is inversely associated with high-sensitivity C-reactive protein

Life’s Essential 8 (LE8) is a score that includes modifiable risk factors for cardiovascular disease. Four health behaviors (diet, physical activity, nicotine exposure and sleep health) and four health factors (non-HDL cholesterol, blood glucose, blood pressure and body mass index) are included. These modifiable risk factors promote inflammation, and inflammation is one of the biological mechanisms of cardiovascular disease development. Thus, we examined the relationship between cardiovascular health measured by LE8 and low-grade inflammation measured by high-sensitivity C-reactive protein (hs-CRP) in the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (SCAPIS). The study consisted of 28,010 participants between 50 and 64 years (51.5% women, mean age 57.5 years). All individual LE8 components were assigned a score between 0 (unhealthy) and 100 (healthy) points, and a global score was calculated. The association between LE8 scores and high-risk hs-CRP (defined as > 3.0 mg/L) was analyzed using adjusted logistic regression with spline analyses. There was a strong, dose response and inverse association between LE8 scores and levels of hs-CRP. Thus, those with a low LE8 score (= 50.0 points) had 5.8 higher (95% confidence interval [CI] 5.2–6.4) odds ratio (OR) of having high hs-CRP as compared to those with a high LE8 score (= 80.0 points). In conclusion, our findings show strong inverse associations between LE8 scores and levels of hs-CRP.