Elevated Fasting Plasma Glucose Research Articles

The association between hypertension and other cardiovascular risk factors among non-diabetic Saudis adults-A cross sectional study.

Population specific associations between cardiovascular disease with various risk factors including pre-hypertension and hypertension were reported. We aimed to investigate the association of higher than optimal blood pressure with measures of dysglycemia, dyslipidemia, and markers of inflammation in non-diabetic Saudi adults hoping to improve current Saudi guidelines to prevent cardiovascular disease. Volunteers were recruited randomly from public healthcare centers in Jeddah. Demographic information, blood pressure (BP), and anthropometric measurements were taken. Fasting blood samples were drawn, then again following 1-hour oral glucose tolerance test. Glycated hemoglobin, fasting plasma glucose (FPG), lipid profile, highly sensitive C- reactive protein, gamma glutamyl transferase, and 1-hour plasma glucose were measured. Complete data was found for 742 men and 592 women. Pre-hypertension was found in 47.2% of men, and 24.7% of women, while 15.1% of men, and 14.6% of women were hypertensive. Means of measured variables differed significantly between normotensive, pre-hypertensive, and hypertensive groups of men and women in gender specific manner. Association between measured variables and elevated BP, and hypertension were assessed using logistic regression models. After adjustment for age, body mass index and waist circumference, elevated blood pressure was associated with elevated triglycerides in men, while hypertension was significantly associated with elevated fasting plasma glucose, total cholesterol, triglycerides, low density lipoprotein- cholesterol, and low high density lipoprotein- cholesterol in men, and elevated triglycerides, and total cholesterol in women. Therefore, it is strongly recommended to measure lipid profile, specifically TG, for all diagnosed pre-hypertensive and hypertensive patients in addition to FPG for men.

Complex patterns of circulating fatty acid levels in gestational diabetes mellitus subclasses across pregnancy

To investigate the relationship between maternal serum fatty acid levels and gestational diabetes mellitus (GDM) subtypes across pregnancy. A total of 680 singleton mothers enrolled in the Complex Lipids in Mothers and Babies (CLIMB) study in Chongqing, China were included. Clinical information and serum samples were collected at gestational weeks (GWs) 11-14, 22-28, and 32-34. 75g Oral Glucose Tolerance Test (OGTT) was conducted at GW 24-28 and GDM subtypes divided into three groups using International Association of Diabetes and Pregnancy Study Group (IADPSG) guidelines criteria: elevated fasting plasma glucose (FPG group; n=59); 1-h and/or 2-h post-load glucose (1h/2h-PG group; n=94); combined group (FPG&1h/2h-PG group; n=42). Non-GDM pregnancies were included (n=485) as controls. Twenty fatty acids were quantified in serum using gas chromatography-mass spectrometry (GC-MS) analysis. Overall, most serum fatty acid concentrations increased rapidly from the first to second trimester, followed by a plateauing or reduction in the third trimester (p<0.001). In cross sectional analysis, fatty acid concentrations were significantly higher in the FPG group at GW 11-14 and decreased in the 1h/2h-PG group at GW 32-34, relative to controls. Moreover, higher α-linolenic acid (ALA; the second tertile: adjusted odds ratio [aOR]=2.53, 95% CI: 1.17 to 5.47; the third tertile: aOR=2.60, 95% CI: 1.20 to 5.65) and docosahexaenoic acid (DHA; the second tertile: aOR=2.34, 95% CI: 1.10 to 4.97; the third tertile: aOR=2.16, 95% CI: 1.00 to 4.63) were significantly associated with a higher risk of GDM in women with elevated fasting plasma glucose at GW 11-14 (first tertile as reference). Our findings highlight the importance of considering GDM subtypes for the individualised management of GDM in pregnancy. ALA and DHA in early pregnancy are associated with a higher risk of FPG-GDM subtype. This has widespread implications when recommending n-3 PUFAs supplementation for women with GDM.

Time-Restricted Eating and Metabolic Syndrome: Current Status and Future Perspectives.

Metabolic syndrome (MetS) occurs in ~30% of adults and is associated with increased risk of cardiovascular disease and diabetes mellitus. MetS reflects the clustering of individual cardiometabolic risk factors including central obesity, elevated fasting plasma glucose, dyslipidemia, and elevated blood pressure. Erratic eating patterns such as eating over a prolonged period per day and irregular meal timing are common in patients with MetS. Misalignment between daily rhythms of food intake and circadian timing system can contribute to circadian rhythm disruption which results in abnormal metabolic regulation and adversely impacts cardiometabolic health. Novel approaches which aim at restoring robust circadian rhythms through modification of timing and duration of daily eating represent a promising strategy for patients with MetS. Restricting eating period during a day (time-restricted eating, TRE) can aid in mitigating circadian disruption and improving cardiometabolic outcomes. Previous pilot TRE study of patients with MetS showed the feasibility of TRE and improvements in body weight and fat, abdominal obesity, atherogenic lipids, and blood pressure, which were observed despite no overt attempt to change diet quantity and quality or physical activity. The present article aims at giving an overview of TRE human studies of individuals with MetS or its components, summarizing current clinical evidence for improving cardiometabolic health through TRE intervention in these populations, and presenting future perspectives for an implementation of TRE to treat and prevent MetS. Previous TRE trials laid the groundwork and indicate a need for further clinical research including large-scale controlled trials to determine TRE efficacy for reducing long-term cardiometabolic risk, providing tools for sustained lifestyle changes and, ultimately, improving overall health in individuals with MetS.

Poverty Status and Clustering of Cardiometabolic Risk Factors and Metabolic Syndrome among African Americans: Results from the National Health and Nutritional Examination Survey 2001-2006

Background: African Americans (AA) are disproportionally affected by cardiovascular disease as compared to other racial-ethnic groups. Exposure to adverse socioeconomic conditions may partially explain disparities in risk factors and prevalence and cardiovascular diseases for AA. We aim to study the impact of poverty status on metabolic syndrome (MetS) and its components among African Americans. Methods: We used data from the National Health and Nutritional Examination Survey (NHANES) cycles 2001-2006. We defined MetS using the Joint Scientific Definition as the presence of any 3/5 components: elevated blood pressure (BP), elevated triglycerides (TGL), lower high-density lipoprotein cholesterol (LDL), elevated fasting plasma glucose (FPG), and elevated waist circumference (WC). Poverty to income ratio (PIR) was categorized as below poverty (3) groups. We used multivariable survey-weighted logistic regression models to study the impact of poverty status of prevalence of MetS and its components among AA men and women. Results: Overall, the average aggregate prevalence of MetS among AA sample was 22% in our study with prevalence being 25% for women and 18% among men (p 3) (OR = 1.57, 95%CI = 1.00 - 2.46, p = 0.05) with no association observed among men (OR (PIR = 1) = 0.70, 95%CI = 0.43 - 1.19, p = 0.13). Further, similar associations were observed for individual components among women including: elevated waist circumference (OR = 2.04, 95%CI = 1.37, 3.01, p 3). No association of poverty status with MetS and its components were observed among AA men. Clustering of factors identified key groups that define MetS among women included WC. Conclusion: African American women living below poverty have a higher likelihood of having MetS and 4 of 5 individual components. Clustering of these factors differ across men and women and should be further explored as tools for clinical management. Main Points: 1) Metabolic syndrome remains an important public health burden among African Americans and shows disparities by socioeconomic status; 2) Women living below poverty were more likely to have MetS and associated components as compared to women living above poverty; 3) Clustering of components gave us snapshot of factors that should be considered to develop gender specific targeted health interventions for MetS among African Americans.

Potential Biomarkers in Early Pregnancy for Predicting Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes.

Gestational diabetes mellitus (GDM) is typically diagnosed based on a 75-g oral glucose tolerance test conducted at 24 - 28 weeks of pregnancy. A method for earlier diagnosis is needed. The present study aimed to identify one or more blood biomarkers detected within the first trimester that can predict the occurrence of GDM and pregnancy outcome. This retrospective study included 2,116 pregnant women who underwent examination and delivery in our hospital between January 2018 and December 2019. The predictive value of various clinical measurements in early pregnancy for predicting GDM and pregnancy outcome was analyzed. The fasting plasma glucose (FPG), vitamin A, vitamin E, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), uric acid, free thyroxine (FT3), anti-peroxidase antibody (TPOAb), and ferritin levels differed significantly between the GDM and non-GDM groups (all p < 0.05). The area under the receiver operating characteristic curve for FPG in GDM diagnosis was 0.766 (95% confidence interval [CI] 0.717 - 0.814, p < 0.001). The odds ratios (ORs) for FPG and TG for GDM prediction were 1.318 (95% CI 1.228 - 1.416) and 2.050 (95% CI 1.203 - 3.493), respectively. The ORs for FPG, vitamin A, and vitamin E for pregnancy outcome prediction were 1.214 (95% CI 1.123 - 1.268), 0.717 (95% CI 0.601 - 0.886), and 0.852 (95% CI 0.761 - 0.954), respectively. Screening of blood biomarkers in early pregnancy may be useful for predicting, and thus preventing, GDM and adverse pregnancy outcomes. Immediate intervention is recommended if an elevated FPG (> 4.7 mmol/L) or TG (> 1.83 mmol/L) level is detected in early pregnancy, and vitamin A, vitamin E, and FT3 levels need to be maintained within normal ranges throughout pregnancy.

The association of cortisol levels with leukocyte distribution is disrupted in the metabolic syndrome

Leukocyte glucocorticoid sensitivity (GCS) pertains to the responsivity of leukocytes to the regulating actions of glucocorticoids, such as cortisol. Impaired endocrine regulation may link the metabolic syndrome (MetS) to the development of cardiovascular disease. We tested if the physiological association between endogenous cortisol levels and peripheral leukocyte composition becomes disrupted in individuals with MetS. MetS was assessed among 689 German industrial employees. The covariance between cortisol levels and hematologic parameters (i.e., proportions of neutrophils and lymphocytes) and their ratio was explored, which has been proposed as a proxy for GCS in vivo. Cortisol level before blood collection was assessed by repeated saliva collection, and the area under the curve was calculated. Linear regression models were adjusted for potential confounders including age, gender, BMI, income, and lifestyle factors. Cortisol levels did not differ between subgroups. Participants without MetS (n = 552) showed the expected association of cortisol with hematologic parameters (β = 0.207 to 0.216; p values < 0.001). No association (β = 0.078 to 0.083; p values > 0.10) was found among those with MetS (n = 137), consistent with a reduced GCS. Analyses of separate MetS components showed that reduced GCS was associated specifically with decreased high-density lipoprotein and elevated fasting plasma glucose. Utilizing a novel statistical approach to infer GCS, this study provided first epidemiological evidence of aberrant physiological regulation of leukocyte distribution by endogenous cortisol levels among individuals with MetS. These findings underline the idea that MetS may involve disruption of endocrine-immune regulation.

Relationship of Glycemic Status with Disease Severity in Guillain-Barré Syndrome

Background: Guillain-Barré syndrome (GBS) is an acute autoimmune polyneuroradiculopathy characterized by flaccid paralysis which may lead to respiratory failure requiring intensive care.&#x0D; Objective: The purpose of the present study was to explore the relationship between the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and disease severity of GBS patients who are not known to have DM.&#x0D; Methodology: This cross-sectional study included adult GBS patients without having DM [age 35 (22-48) years, median (interqurtile range, IQR); 39 male 22 female] who were admitted to Neurology department, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 2018 to June 2019. Demographics, clinical data were noted and FPG, HbA1c were measured. Disease severity were assessed by the GBS disability scale ranging from 0 to 6 with increasing score reflecting increased disability.&#x0D; Results: Patients with more severe GBS (disability score ≥4, unable to walk) had higher frequency of elevated FPG &gt;5.5 mmol/L (61.2%; 30/49) in comparison to those with less severe GBS (disability score ≤3, able to walk; FPG &gt;5.5 mmol/L in 16.7%, 2/12; p=0.006). But distribution of HbA1c category was not different across the groups (disability score ≥4 vs. ≤3: HbA1c &lt;5.7: 40% vs. 58%; 5.7-6.4: 50% vs. 25%; &gt;6.4: 10% vs. 17%; p=0.296). Participants with elevated FPG were elder [elevated vs. normal FPG: 40 (28-54) vs. 25 (19-43) years; median (IQR), p=0.012] and had higher CSF glucose (p=0.002) than those with normal FPG, but there was no difference in respct of gender, MRC sum score, requirement of assisted ventilation, CSF protein, GBS subtypes and duration of hospital stay (p=not significant for all).&#x0D; Conclusions: Patients with severe GBS have higher frequency of elevated FPG but not HbA1c. An acute change in glucose metabolism may occur in GBS which needs further study.&#x0D; Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 96-100

Sex-specific associations of plasma metals and metal mixtures with glucose metabolism: An occupational population-based study in China

Studies with multi-pollutant approach on the relationships between multiple metals and fasting plasma glucose (FPG) are limited. Few studies are available on the potential sex-specific associations between metal exposures and glucose metabolism. We explored the associations between 22 plasma metals and FPG level among the 769 participants from the manganese-exposed workers healthy cohort in China. We applied a sparse partial least squares (sPLS) regression followed by ordinary least-squares regression to evaluate multi-pollutant association. Bayesian kernel machine regression (BKMR) model was used to deal with metal mixtures and evaluate their joint effects on FPG level. In the sPLS model, negative associations on FPG levels were observed for plasma iron (belta = −0.066), cobalt (belta = −0.075), barium (belta = −0.109), and positive associations for strontium (belta = 0.082), and selenium (belta = 0.057) in men, which overlapped with the results among the overall participants. Among women, plasma copper (belta = 0.112) and antimony (belta = 0.137) were positively associated with elevated FPG level. Plasma magnesium was negatively associated with FPG level in both sexes (belta = −0.071 in men and belta = −0.144 in women). The results of overlapped for plasma magnesium was selected as the significant contributor to decreasing FPG level in the multi-pollutant, single-metal, and multi-metal models. BKMR model showed a significantly negative over-all effect of six metal mixtures (magnesium, iron, cobalt, selenium, strontium and barium) on FPG level among the overall participants from all the metals fixed at 50th percentile. In summary, our findings underline the probable role of metals in glucose homeostasis with potential sex-dependent heterogeneities, and suggest more researches are needed to explore the sex-specific associations of metal exposures with risk of diabetes.

Admission fasting plasma glucose is an independent risk factor for 28-day mortality in patients with COVID-19.

Hyperglycemia commonly occursin severe cases with COVID-19. In this study, we explored the associations between admission fasting plasma glucose (FPG) and 28-day mortality in COVID-19 patients. In this single centre retrospective study, 263 adult patients with COVID-19 were included. Demographic and clinical information were collected and compared between patients with and without diabetes. Cox regression analyses were used to investigate the risk factors of 28-day mortality in hospitals. Of 263 patients, 161 (61.2%) were male, 62 (25.6%) had a known history of diabetes, and 135 (51.3%) experienced elevated FPG (>7.0 mmol/L) at hospital admission. The median FPG in patients with diabetes was much higher than in patients without diabetes (12.79vs. 6.47 mmol/L). Patients with diabetes had higher neutrophil count and D-dimer, less lymphocyte count, lower albumin level, and more fatal complications. Multivariable Cox regression analyses showed that age (per 10-year increase) (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.13-1.74), admission FPG between 7.0 and 11.0and≥11.1 mmol/L (HR, 1.90; 95% CI, 1.11-3.25and HR, 2.09; 95% CI, 1.21-3.64, respectively), chronic obstructive pulmonary disease (HR, 2.89; 95% CI, 1.31-6.39), and cardiac injury (HR, 2.14; 95% CI, 1.33-3.47) were independent predictors of 28-day mortality in COVID-19 patients. Hyperglycemia on admission predicted worse outcome in hospitalized patients with COVID-19. Intensive monitoring and optimal glycemic control may improve the prognosis of COVID-19 patients.

Association of hyperglycaemia with periodontal status: Results of the Northern Finland Birth Cohort 1966 study.

To investigate the association of hyperglycaemia and changes in glycaemic control with periodontal status in non-diabetic individuals. A sub-population (n=647) of the Northern Finland Birth Cohort 1966 was studied. We categorized long-term glucose balance based on fasting plasma glucose (FPG) at ages 31 and 46: FPG <5.0mmol/l (strict normoglycaemia), FPG 5.0-5.59mmol/l (slightly elevated FPG) and FPG 5.6-6.9mmol/l (prediabetes). Probing pocket depth (PPD) and alveolar bone level (BL) data were collected at age 46. Relative risks (RR, 95% CI) were estimated using Poisson regression models. Periodontal status was poorer in individuals whose glucose balance worsened from age 31 to 46years than in those with a stable glucose balance. In the case of strict normoglycaemia at age 31 and slightly elevated FPG or prediabetes at age 46, the RRs for PPD ≥4mm were 1.8 (95% CI 1.4-2.2) and 2.8 (95% CI 2.0-3.8) and for BL ≥5mm 1.1 (95% CI 0.8-1.4) and 1.8 (95% CI 1.2-2.8), respectively. The results of this population-based cohort study suggest that impairment in glucose control in non-diabetic individuals is associated with periodontal pocketing and alveolar bone loss.

Lifestyle Intervention With or Without Lay Volunteers to Prevent Type 2 Diabetes in People With Impaired Fasting Glucose and/or Nondiabetic Hyperglycemia

Nearly half of the older adult population has diabetes or a high-risk intermediate glycemic category, but we still lack trial evidence for effective type 2 diabetes prevention interventions in most of the current high-risk glycemic categories. To determine whether a group-based lifestyle intervention (with or without trained volunteers with type 2 diabetes) reduced the risk of progression to type 2 diabetes in populations with a high-risk glycemic category. The Norfolk Diabetes Prevention Study was a parallel, 3-arm, group-based, randomized clinical trial conducted with up to 46 months of follow-up from August 2011 to January 2019 at 135 primary care practices and 8 intervention sites in the East of England. We identified 141 973 people at increased risk of type 2 diabetes, screened 12 778 (9.0%), and randomized those with a high-risk glycemic category, which was either an elevated fasting plasma glucose level alone (≥110 and <126 mg/dL [to convert to millimoles per liter, multiply by 0.0555]) or an elevated glycated hemoglobin level (≥6.0% to <6.5%; nondiabetic hyperglycemia) with an elevated fasting plasma glucose level (≥100 to <110 mg/dL). A control arm receiving usual care (CON), a theory-based lifestyle intervention arm of 6 core and up to 15 maintenance sessions (INT), or the same intervention with support from diabetes prevention mentors, trained volunteers with type 2 diabetes (INT-DPM). Type 2 diabetes incidence between arms. In this study, 1028 participants were randomized (INT, 424 [41.2%] [166 women (39.2%)]; INT-DPM, 426 [41.4%] [147 women (34.5%)]; CON, 178 [17.3%] [70 women (%39.3)]) between January 1, 2011, and February 24, 2017. The mean (SD) age was 65.3 (10.0) years, mean (SD) body mass index 31.2 (5) (calculated as weight in kilograms divided by height in meters squared), and mean (SD) follow-up 24.7 (13.4) months. A total of 156 participants progressed to type 2 diabetes, which comprised 39 of 171 receiving CON (22.8%), 55 of 403 receiving INT (13.7%), and 62 of 414 receiving INT-DPM (15.0%). There was no significant difference between the intervention arms in the primary outcome (odds ratio [OR], 1.14; 95% CI, 0.77-1.7; P = .51), but each intervention arm had significantly lower odds of type 2 diabetes (INT: OR, 0.54; 95% CI, 0.34-0.85; P = .01; INT-DPM: OR, 0.61; 95% CI, 0.39-0.96; P = .033; combined: OR, 0.57; 95% CI, 0.38-0.87; P = .01). The effect size was similar in all glycemic, age, and social deprivation groups, and intervention costs per participant were low at $153 (£122). The Norfolk Diabetes Prevention lifestyle intervention reduced the risk of type 2 diabetes in current high-risk glycemic categories. Enhancing the intervention with DPM did not further reduce diabetes risk. These translatable results are relevant for current diabetes prevention efforts. ISRCTN Registry Identifier: ISRCTN34805606.

Prevalence, combinations and associations of components of MetS among adults aged 40 years and above from rural Kerala: a cross-sectional study

Background: Metabolic syndrome (MetS) is a growing public health concern worldwide. A nation-wide diabetes screening campaign by the union health ministry found rural areas of selected district of Kerala had16% prevalence of lifestyle diseases. One of the objectives of WHO developed action plan for global implementation of strategies in prevention and control of non-communicable diseases (NCDs) advocates identifying MetS, a simple clinical tool, for predicting diabetes mellitus and cardiovascular diseases among population. The study aimed to estimate the prevalence of metabolic syndrome and its components among the adults aged 40 and above from rural Kerala and to determine the association with socio-demographic characteristics like co-variables of the study population.Methods: A cross-sectional study conducted among adult subjects aged 40 and above from rural field practice areas visiting RHTC. Socio-demographic profile, personal habits and history on NCDs recorded. Blood pressure and abdominal circumference measured. Fasting plasma glucose (FPG), triglyceride (TG), and high-density lipoprotein (HDL) levels were estimated. Modified NCEP-ATP III (SAS), 2009 criteria was used to diagnose MetS. Study variables were analysed for associations and comparison of means with appropriate statistical methods.Results: The prevalence of metabolic syndrome (MetS) was 29.3%. 57.9% elevated FPG, 37% Triglyceridemia, 24% sub-optimal HDL, 38.3% abdominal obesity, 38.3% elevated BP, 52% insulin resistance were recorded. Among MetS subjects 50% were in 50-59 years age group and MetS had statistically significant association with age (p value 0.005).Conclusions: Moderate prevalence of metabolic syndrome among rural subjects needs strengthening health education and screening services on NCDs.

Increased Stroke Risk in Metabolically Abnormal Normal Weight: a 10-Year Follow-up of 102,037 Participants in China.

The purpose of this study was to investigate the risks of stroke in subjects with metabolically abnormal normal weight (MANW) in China. We recruited 102,037 participants from the Zhejiang Metabolic Syndrome Cohort and the Kailuan cohort. The mean years of follow-up were 9.9years. General obesity was defined by body mass index (BMI) ≥ 28, overweight by BMI < 28 and ≥ 24, and normal weight by BMI < 24 and ≥ 18.5. Metabolic abnormality was defined as two or more abnormal components (elevated triglycerides, low high-density lipoprotein cholesterol, elevated systolic blood pressure or diastolic blood pressure, or use of antihypertensive drug therapy, elevated fasting plasma glucose, or antidiabetic treatment). A multiple Cox regression model was used to calculate hazard ratio (HR) and its 95% confidence interval (CI), adjusted by potential confounding factors. Overall HR of the risks in two cohorts was calculated by a meta-analysis. Compared with the subjects who were metabolically normal with normal weight (MNNW), the pooled HR for stroke in MANW subjects was 1.82 (95% CI, 1.59-2.07). The risks of stroke in MANW subjects were significantly lower than that in subjects with metabolically abnormal obesity (MAO), but higher than that in those with metabolically normal obesity (MNO) (P < 0.05). These associations remained in the subtypes of cerebral infarction and cerebral hemorrhage. In normal-weight subjects, the HR for stroke was significantly positively correlated with the number of abnormal metabolic components (Ptrend < 0.001). In brief, metabolic abnormality increased the risk of stroke irrespective of obesity status. MANW individuals showed a greater risk of stroke, and this risk was positively correlated with the number of abnormal metabolic components.

Visceral Adiposity and Glucoregulatory Peptides are Associated with Susceptibility to Type 2 Diabetes: The TOFI_Asia Study.

Ethnic differences in fat deposition contribute to type 2 diabetes (T2D). Identification of biomarkers that underpin dysglycemia are needed for better-targeted prevention and treatment. The cross-sectional thin-on-the-outside-fat-on-the-inside (TOFI)_Asia study investigated adipose depots and clinical biomarkers as predictors of fasting plasma glucose (FPG) and insulin resistance (IR; assessed using the updated homeostatic model assessment of IR) in lean and overweight normo- and dysglycemic Chinese (n = 199) and Caucasian (n = 158) individuals. Multivariate least-angle regression models were used to identify predictors of FPG and IR. At similar age and BMI, Chinese individuals had lower body weight but had a greater percentage of total abdominal adipose tissue and a greater percentage of total visceral adipose tissue (VAT) (all P < 0.005). In Chinese individuals, FPG, hemoglobin A1c , fasting insulin, and triglycerides were higher, whereas HDL cholesterol and total and high-molecular-weight adiponectin levels were lower (all P < 0.0001). Raised liver enzyme and peptide concentrations (P < 0.02) were consistent with increased T2D risk. Lean Chinese women (<25 kg/m2 ) had greater total abdominal adipose tissue (kilograms) and VAT (kilograms) than Caucasian women, exhibiting the TOFI profile, with raised FPG (P < 0.001) and IR (P = 0.01). Risk factors for elevated FPG specific to Chinese individuals included male gender, VAT, and triglycerides (R2 = 0.33), and risk factors for IR specific to Chinese individuals included amylin, C-peptide, and glucagon (R2 = 0.49). VAT, amylin, and C-peptide were predictors in Caucasian individuals. VAT contributed to dysglycemia in both ethnicities, particularly in Chinese individuals characterized by the TOFI phenotype, as did the glucoregulatory peptides amylin and C-peptide, providing targets for T2D prevention.

Analysis of Nidan (Etiological Factors) Of Metabolic Syndrome.

Metabolic syndrome is a clustering of at least three of these-Abdominal (central) obesity, Elevated bloodpressure, Elevated fasting plasma glucose, High serum triglycerides and Low high-density lipoprotein (HDL)levels. In recent years, there is an alarming increase in metabolic syndrome. The overall prevalence rate ofmetabolic syndrome is 33.5%. It is 24.9% in males and 42.3% in females. The terminology ‘Metabolicsyndrome’ represents its relation with metabolism. It can be said that disequilibrium of metabolism causesmetabolic syndrome. The word metabolism can be correlated with ‘concept of Agni’ described in Ayurvedabecause entire range of digestive and metabolic activities of the body take place with the help of the biologicalfire of the body called Agni. This study was conducted to explore the nidan (Etiological factors) of metabolicsyndrome based on basic concepts of Ayurveda and it suggest to think about overcoming mental stress (asone of the prominent etiological factor) while managing Metabolic syndrome.

Fasting plasma glucose, lipid ratios, and atherogenic coefficient are the risk factors for hypertension in chronic kidney disease patients on hemodialysis: A report from the Regional High Speciality Hospital of Peninsular Yucatan, Mexico

Chronic kidney disease (CKD) is associated with the development of cardivascular disease (CVD). CKD is one of the major public health problems in Mexico. Derived parameters of lipid profile, namely atherogenic index of plasma (AIP), atherogenic coefficient (AC), and Castelli risk index (CRI I and CRI II) are useful for predicting hypertension among CKD patients on hemodialysis that are not widely reported from Mexico. Objective of the present study was to find interrelationships among blood pressure, fasting plasma glucose (FPG), and derived parameters of lipid profile (AIP, AC, CRI-I, and CRI-II) among adult CKD patients on hemodialysis in a hospital in Yucatan, Mexico. Methods: An observational study was performed using the medical records (2016 and 2017) of 47 CKD patients on hemodialysis in the Regional High Speciality Hospital of Yucatan Peninsula (HRAEPY in Spanish acronym). Multiple linear regression models were developed to evaluate the use of FPG level and derived parameters of lipid profile (AC, CRI-I, and CRI-II) as risk factors predicting mean arterial pressure (MAP). Results showed remarkable prevalence of excess weight (55% overweight, 15% obesity) and hypertension (64%) in the sample. Correlation coeffcients and multiple linear regression models showed significant rise of blood pressure in association with elevated FPG level and derived lipid profile parameters. The results confirm the use of FPG, AC, CRI-I and CRI-II as the indicators for an early diagnosis of hypertension and related CVDs among CKD patients on hemodialysis.

Diabetes in urban Guinea-Bissau; patient characteristics, mortality and prevalence of undiagnosed dysglycemia

ABSTRACT Background The burden of diabetes mellitus in Sub-Saharan Africa is growing rapidly, and yet the prevalence and patient characteristics are still largely unknown. Objectives We analyzed clinical and demographic characteristics of Type 2 diabetes (T2DM) patients attending a diabetes clinic in Guinea-Bissau from February 2008 to April 2014, and estimated the prevalence and risk factors of unknown-impaired fasting plasma glucose (FPG) and diabetes, as well as excess mortality associated with T2DM. Methods We characterized T2DM patients attending the national diabetes clinic in Bissau. Diabetes was diagnosed based on FPG. We matched T2DM patients 1:1 with non-diabetes community controls on age and sex to determine relevant risk factors for T2DM using logistic regression. Furthermore, we matched patients 1:6 with community controls to assess long-term survival (until February 2019) in a Cox regression using calendar time as the underlying timescale. Verbal autopsies determined the cause of death among T2DM patients and controls. Results The mean age among T2DM was 50.6 (SD 11.1), and the mean FPG at first consultation was high (13.2 mmol/L (SD 5.1)). Ethnicity, family history of diabetes, hypertension, and anthropometrics differed among T2DM patients, community controls with impaired FPG, and healthy controls. Family history of diabetes (OR = 5.65, 95% CI: 3.10–10.3) and elevated waist circumference (2.33, 1.26–4.29) were significant risk factors for T2DM. 20.4% (59/289) of community controls had abnormal FPG. T2DM patients had an excess mortality hazard ratio of 3.53 (95%CI: 1.92–6.52). Deaths caused by bacterial infections, including foot ulcers, were more common among T2DM patients, compared with community controls (54% (7/13) vs. 19% (5/27) (P = 0.02)). Conclusion Several risk factors including were associated with T2DM in Guinea-Bissau. We found a high prevalence of elevated FPG among randomly selected community controls. In combination with higher mortality among T2DM patients, an urgent need for better treatment options and increased awareness.

HIV and metabolic syndrome in an Ethiopian population

Background The global prevalence of metabolic syndrome (MS) is increasing due to lifestyle changes. Studies have found that MS is associated with human immunodeficiency virus (HIV) and antiretroviral treatment (ART), but controversies still exist on associations between HIV and MS. Aims To assess associations between HIV and MS among ART-naïve HIV positive individuals compared to HIV negative individuals. Subjects and methods A cross-sectional study among ART-naïve HIV positive and HIV negative individuals recruited from HIV treatment and testing facilities in Ethiopia. Information was collected on components of MS: waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL-C), blood pressure and fasting plasma glucose (FPG). Data were analysed using logistic and linear regression stratified by sex and adjusted for age, wealth and education. Results Data from 329 HIV positive and 100 HIV negative individuals were included. HIV positive status was associated with higher odds of MS in women (OR: 3.56, 95%CI: 1.25; 10.15) (n = 292), but not in men (OR: 0.98, 95%CI: 0.22; 4.30) (n = 137), interaction: p= .11. Associations between HIV and components of MS were strongest for HDL-C among women and for FPG among men. The most prevalent components of MS in HIV positive individuals were elevated triglycerides, reduced HDL-C and elevated FPG. Conclusions HIV was associated with MS among ART-naïve women, suggesting that MS should be evaluated before initiating ART and monitored during treatment to identify those at risk of developing diabetes and cardiovascular disease (CVD).

The role of impaired glucose and lipid metabolism and liver enzyme abnormalities in the formation of multiple acrochordons: a case-control study

Background Acrochordons, one of skin tumors, are protrusions of the loose fibrous tissue. In various studies, they have found to be associated with abnormal lipid profile, diabetes, cardiovascular disease, obesity, abnormal liver enzymes and genetic factors. In our case-control study, we aimed to determine possible associations of multiple acrochordons with obesity, impaired glucose and lipid metabolism, thyroid disorders, anemia and liver enzymes abnormalities.Methods Sixty-five patients (32 male, 33 female) with at least 8 skin tags and age- and gender-matched 60 controls without skin tags (30 male, 30 female) were enrolled to the study. We noted patients’ and controls’ age, height, weight, body mass index (BMI) and detailed medical history. Locations of acrochordons were recorded for the patient group. We recorded values of fasting plasma glucose, insulin, homeostatic model assessment insulin resistance (HOMA-IR), total cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), free T3 (fT3), free T4 (fT4), thyroid-stimulating hormone (TSH), hemoglobin, ferritin, vitamin B12, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP).Results Our study has shown a genetic predisposition to the development of multiple skin tags (P=0.0001). The mean BMI was statistically significant between the patients and controls (P&amp;lt;0.0001). In addition, we have found that when fasting plasma glucose, AST and GGT levels increase, the possibility of the forming of multiple acrochordons also increases (P=0.048, P=0.003, P=0.013). We determined that increasing of BMI is a risk factor for both genders (P=0.003, P&amp;lt;0.0001, respectively). We found that elevated fasting plasma glucose, insulin, HOMA-IR, total cholesterol, triglyceride, AST, ALT and GGT levels increase possibility of the forming of multiple acrochordons in females (P=0.037, P=0.022, P=0.013, P=0.03, P=0.007, P&amp;lt;0.0001, P=0.015, P=0.005, respectively).Conclusion Our results show that multiple acrochordons may be the cutaneous signs of abnormal glucose and lipid metabolism and liver enzyme abnormalities. Thus, we suggest that clinicians should see appropriate bloodtests for patients with multiple skin tags and manage them accordingly.

1244-P: Impact of Maternal Fasting Glucose in Pregnancy on Excess Weight at Preschool Age in the Offspring

Aim: To examine the association between elevated maternal fasting plasma glucose (FPG) during pregnancy and obesity in the offspring. Methods: For women without pre-existing diabetes in 2 zones in Alberta, Canada with births between 2005 - 2013, maternal data were linked to offspring’s birth registry and preschool immunization records (w/height, weight) between 2009-2017. A 50-g glucose challenge test (GCT) followed by a 75-g OGTT was used to diagnose GDM. Pregnancies were grouped as follows: 1) GCT negative; 2) OGTT negative; 3) elevated FPG on the OGTT; and 4) elevated 1-hour and/or 2-hour OGTT only. WHO criteria were used to identify children who were overweight, obese, or extremely obese. Results: Of 79,156 pregnancies, 80.3% were GCT negative, 14.7% were OGTT negative, 1.3% had elevated FPG, and 3.7% had elevated post-load glucose only. Both LGA and pre-school obesity rates were highest in pregnancies with abnormal FPG (Figure). Relative to children of GCT negative pregnancies, children of pregnancies with elevated maternal FPG had adjusted odds ratio (aOR, 95% CI) 3.0, (2.6-3.6) for LGA; and aOR 1.3 (1.1 - 1.6) for overweight, aOR 2.4 (1.9 - 3.0) for obesity, aOR 3.5 (2.7 - 4.7) for extreme obesity at preschool age. Conclusion: The effect of elevated maternal FPG in pregnancy on offspring weight extends to early childhood. These children may be candidates for early pediatric weight and health interventions. Disclosure P. Kaul: None. A. Savu: None. L.E. Moore: None. R.O. Yeung: Research Support; Self; AstraZeneca, Novo Nordisk Inc. Speaker’s Bureau; Self; Merck &amp; Co., Inc. E.A. Ryan: None. Funding Canadian Institutes of Health Research; University Hospital Foundation