Elevated Fasting Serum Glucose Research Articles

Glucoregulatory Properties of a Protein Hydrolysate from Atlantic Salmon (Salmo salar): Preliminary Characterization and Evaluation of DPP-IV Inhibition and Direct Glucose Uptake In Vitro.

Metabolic disorders are increasingly prevalent conditions that manifest pathophysiologically along a continuum. Among reported metabolic risk factors, elevated fasting serum glucose (FSG) levels have shown the most substantial increase in risk exposure. Ultimately leading to insulin resistance (IR), this condition is associated with notable deteriorations in the prognostic outlook for major diseases, including neurodegenerative diseases, cancer risk, and mortality related to cardiovascular disease. Tackling metabolic dysfunction, with a focus on prevention, is a critically important aspect for human health. In this study, an investigation into the potential antidiabetic properties of a salmon protein hydrolysate (SPH) was conducted, focusing on its potential dipeptidyl peptidase-IV (DPP-IV) inhibition and direct glucose uptake in vitro. Characterization of the SPH utilized a bioassay-guided fractionation approach to identify potent glucoregulatory peptide fractions. Low-molecular-weight (MW) fractions prepared by membrane filtration (MWCO = 3 kDa) showed significant DPP-IV inhibition (IC50 = 1.01 ± 0.12 mg/mL) and glucose uptake in vitro (p ≤ 0.0001 at 1 mg/mL). Further fractionation of the lowest MW fractions (<3 kDa) derived from the permeate resulted in three peptide subfractions. The subfraction with the lowest molecular weight demonstrated the most significant glucose uptake activity (p ≤ 0.0001), maintaining its potency even at a dilution of 1:500 (p ≤ 0.01).

More rapid bone mineral density loss in older men with diabetes: The Osteoporotic Fractures in Men (MrOS) Study.

Type 2 diabetes mellitus (T2D) is associated with more rapid bone loss in women, but less evidence is available for men or those with prediabetes. To determine whether bone loss rate is affected by diabetes status in older men, we analyzed data from the Osteoporotic Fractures in Men (MrOS) study. The multisite MrOS study enrolled 5,994 men aged ≥65 years. Diabetes status was defined by self-report, diabetes medication use, or elevated fasting serum glucose at baseline. Hip bone mineral density (BMD) was measured by dual energy x-ray absorptiometry (DXA) at baseline and a follow-up visit after 4.6 ± 0.4 years. This analysis included 4095 men, excluding those without a follow-up DXA or with unknown diabetes status. Changes in hip BMD in participants with normoglycemia (NG), prediabetes, or T2D, excluding thiazolidinedione (TZD) users, were evaluated using generalized linear models (GLM). Diabetes medication use and BMD loss among those with T2D were also evaluated with GLM. In adjusted models, loss in hip BMD was greater in men with T2D (- 2.23%: 95% CI: -2.54 to -1.91; p<0.001) but not in men with prediabetes (-1.45%; 95% CI -1.63 to -1.26; p=0.33) compared to NG (-1.57%: 95% CI -1.73 to -1.41). Among men with T2D, TZD, insulin and sulfonylurea use were associated with greater hip BMD loss. Men with T2D, but not prediabetes, experienced an accelerated bone loss compared to participants with normoglycemia. More rapid bone loss predicts increased risk of fractures and mortality in broader populations.

Association of post-smoking cessation changes in fasting serum glucose with changes in predicted fatty liver score

Major post-cessation metabolic changes include weight gain and hyperglycemia. However, the association of post-cessation change in fasting serum glucose (FSG) with risk of fatty liver remains unclear. A total of 111,106 participants aged 40 and above who underwent health screening at least once in two examination periods were extracted from the Korean National Health Insurance Service-National Sample Cohort. Fatty liver status was evaluated using the Korean National Health and Nutrition Examination Survey nonalcoholic fatty liver disease (K-NAFLD) score. Linear and logistic regression were used to calculate the adjusted mean (aMean) and adjusted odds ratio (aOR) with 95% confidence intervals. Compared to stable (aMean 0.10; 95% CI 0.03–0.18) and decline (aMean − 0.60; 95% CI − 0.71 to 0.49) groups, FSG elevation (aMean 1.28; 95% CI 1.16–1.39) was associated with higher K-NAFLD score even within different body mass index change groups. Risk of fatty liver was significantly reduced among participants with stable (aOR 0.38; 95% CI 0.31–0.45) and declined (aOR 0.17; 95% CI 0.13–0.22) FSG levels after smoking cessation compared to FSG elevation group. This study suggests that quitters with elevated FSG are associated with higher NAFLD risk and may benefit from careful monitoring of FSG levels and management of other cardiovascular risk factors.

Interaction of Polygenetic Variants for Gestational Diabetes Mellitus Risk with Breastfeeding and Korean Balanced Diet to Influence Type 2 Diabetes Risk in Later Life in a Large Hospital-Based Cohort.

The etiologies of gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) are similar. Genetic and environmental factors interact to influence the risk of both types of diabetes. We aimed to determine if the polygenetic risk scores (PRS) for GDM risk interacted with lifestyles to influence type 2 diabetes risk in women aged >40 years in a large hospital-based city cohort. The participants with GDM diagnosis without T2DM before pregnancy were considered the case group (n = 384) and those without GDM and T2DM as the control (n = 33,956) to explore GDM-related genetic variants. The participants with T2DM were the case (n = 2550), and the control (n = 33,956) was the same as GDM genetic analysis for the interaction analysis of GDM genetic risk with lifestyles to influence T2DM risk. The genetic variants for the GDM risk were selected from a genome-wide association study (GWAS), and their PRS from the best model with gene-gene interactions were generated. GDM was positively associated with age at first pregnancy, body mass index (BMI) at age 20, and education level. A previous GDM diagnosis increased the likelihood of elevated fasting serum glucose concentrations and HbA1c contents by 8.42 and 9.23 times in middle-aged and older women. However, it was not associated with the risk of any other metabolic syndrome components. Breast-feeding (≥1 year) was inversely associated with the T2DM risk in later life. In the genetic variant-genetic variant interaction, the best model with 5-SNPs included PTPRD_rs916855529, GPC6_rs9589710, CDKAL1_rs7754840, PRKAG2_rs11975504, and PTPRM_rs80164908. The PRS calculated from the 5-SNP model was positively associated with the GDM risk by 3.259 (2.17–4.89) times after adjusting GDM-related covariates. The GDM experience interacted with PRS for the T2DM risk. Only in non-GDM women PRS was positively associated with T2DM risk by 1.36-times. However, long breastfeeding did not interact with the PRS for T2DM risk. Among dietary patterns, only a Korean-style balanced diet (KBD) showed an interaction with PRS for the T2DM risk. Participants with a low-PRS had the lowest serum glucose concentrations in the high KBD intake but not low KBD intake. In conclusion, participants with a high PRS for GDM risk are positively associated with T2DM risk, and breastfeeding for ≥1 year and consuming KBD offset the PRS for GDM risk to influence T2DM risk in middle-aged and older.

Sociodemographic Factors, Health Behaviors, and Biological Indicators Associated With Suicide Mortality Among Young Adults in South Korea: A Nationwide Cohort Study Among 15 Million Men and Women.

The role of sociodemographic factors, health behaviors, and biological indicators as potential risk factors for suicide is relatively understudied among young adults. The aim of this study is to explore the association of these variables with the risk of death by suicide among young adults. The study population consisted of 15,534,438 individuals aged 20-39 years from the Korean National Health Insurance Service. Sociodemographic factors associated with death by suicide during 2006-2015 were evaluated. 3,396,353 individuals who underwent health examinations between 2002 and 2005 were separately assessed for health behaviors and biological indicators associated with death by suicide. Cox proportional hazards regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for suicide mortality according to sociodemographic factors (age, household income, job status, residence, and Charlson comorbidity index score), health behaviors (physical activity, smoking, and alcohol consumption), and biological indicators (blood pressure, total cholesterol level, body mass index, and fasting serum glucose level). Low household income, self- and non-employment, increased comorbidity, smoking, and normal weight elevated the risk of death by suicide among young adults. While older age was associated with elevated risk for death by suicide among men (adjusted HR [aHR] = 2.11; 95% CI, 2.02-2.20 for men aged 35-39 years), older age reduced the risk for death by suicide among women (aHR = 0.72; 95% CI, 0.69-0.75 for women aged 35-39 years). Elevated blood pressure and fasting serum glucose level were associated with increased risk for death by suicide among men (aHR = 1.16; 95% CI, 1.05-1.28 and aHR = 1.48; 95% CI, 1.26-1.75, respectively). Finally, high total cholesterol levels were associated with increased risk for death by suicide among women (aHR = 1.59; 95% CI, 1.19-2.13). Sociodemographic factors, health behaviors, and biological indicators were associated with suicide mortality among young adults.

Effects of enalapril and paricalcitol treatment on diabetic nephropathy and renal expressions of TNF-α, p53, caspase-3 and Bcl-2 in STZ-induced diabetic rats.

This study aimed to assess the renopreventive effect of enalapril and/or paricalcitol on streptozotocin (STZ) diabetes-induced nephropathy and to elucidate their mechanisms of action through investigation of the effects on renal oxidative stress, antioxidant defense system and expressions of TNF-α, p53, caspase-3, and Bcl-2. Diabetes mellitus was induced in fasting male Wistar rats by single intraperitoneal injection of STZ (45 mg /kg b.w.) dissolved in citrate buffer (pH 4.5). Ten days after STZ injection, the diabetic rats were treated with enalapril (25 mg/l of drinking water) and/or paricalcitol (8 μg/kg b.w. per os) dissolved in 5% DMSO daily for 4 weeks. The obtained data revealed that the treatment of diabetic Wistar rats with enalapril and/or paricalcitol led to significant decreases in the elevated serum urea, uric acid, creatinine, sodium and potassium levels; thereby reflecting the improvement of the impaired kidney function. The deteriorated kidney lipid peroxidation, GSH content and GST and catalase activities in diabetic rats were significantly ameliorated as a result of treatment with enalapril and/or paricalcitol. The elevated fasting and post-prandial serum glucose levels and the lowered serum insulin and C-peptide levels were also improved. The treatment with enalapril and paricalcitol in combination was the most potent in decreasing the elevated serum glucose levels. Moreover, the treatment of diabetic rats successfully prevented the diabetes-induced histopathological deleterious changes of kidney and islets of Langerhans of pancreas. In association, the immunohistochemically detected pro-inflammatory cytokine, TNF-α, and apoptotic mediators, p53 and caspase-3, were remarkably decreased in kidney of diabetic rats as a result of treatment while the expression of anti-apoptotic protein Bcl-2 was increased. Based on these findings, it can be concluded that enalapril and paricalcitol alone or in combination can prevent STZ diabetes-induced nephropathy through amelioration of the glycemic state and antioxidant defense system together with the suppression of oxidative stress, inflammation and apoptosis. However, the treatment of diabetic rats with enalapril and paricalcitol in combination has no further significant improvement effects on renal function and damage when compared with enalapril or paclitaxel treated diabetic groups.

Elevated fasting serum glucose levels increase the risk of hepatocellular carcinoma

Previous studies have demonstrated a positive relationship between liver cancer and diabetes mellitus. However, elevated fasting blood glucose (FBG) itself may be a risk factor for the development of hepatocellular carcinoma (HCC) rather than diabetes, and during the follow-up period, death is an event that may occur before the occurrence of HCC, which should be dealt with competing risk models. Our study aims to investigate the relationship between FBG and new-onset HCC by using competing risk regression models.We prospectively studied the relationship between FBG concentrations and risk of HCC in a cohort of 93,447 participants who were free of prior HCC, and whose demographic characteristics and biochemical parameters were recorded. Cox proportional hazards regression models and competing risk regression models were used to evaluate the association between FBG concentrations and risk of incident HCC.A total of 302 participants were diagnosed with HCC among 93,447 subjects during 810,499 person-years of follow-up. The multivariable hazard ratios (HRs) [95% confidence interval (95% CI)] for the association of FBG and log(FBG) with HCC were 1.07 (1.01∼1.12), 1.84 (1.23∼2.74) in an analysis adjusted for other potential variables. In the multivariable adjusted analysis, participants who were in 4.82 mmol/L≤FBG≤5.49 mmol/L group and FBG >5.49 mmol/L group would have increased the risk of HCC by 47% and 69%, respectively. In a cause-specific hazard model (CS model), the multivariable HRs (95% CI) for the association of FBG with HCC were 1.46 (1.09∼1.98), 1.69 (1.27∼2.27) in the multivariable adjusted analysis. Similar results were also observed in sub-distribution hazard function model (SD model) with corresponding multivariate HRs (95% CI) of 1.46 (1.09∼2.00), 1.69 (1.25∼2.27) in 4.82 mmol/L≤FBG≤5.49 mmol/L group and FBG >5.49 mmol/L group, respectively.Higher FBG concentrations itself were positively associated with new-onset HCC in the Cox proportional hazards regression models and competing risk models. FBG concentrations can be used as a scientific and important way to identify individuals with a higher risk of HCC and control of FBG concentrations might serve as a possible way to decrease the risk of HCC among Chinese population.Trial registration: ChiCTR-TNRC-11001489. Registered August 24, 2011 (retrospectively registered).

Electroacupuncture Reduces Body Weight by Regulating Fat Browning-Related Proteins of Adipose Tissue in HFD-Induced Obese Mice.

Objective: This study investigated the influence of electroacupuncture (EA) and its potential underlying mechanisms on adipose tissue in obese mice. Methods: Three-week-old male C56BL/6 mice were randomly divided to feed or not to feed high-fat diet (HFD), named HFD group and chow diet (CD) group, respectively. After 12 weeks, CD and HFD mice were randomly divided into two groups, respectively, to receive or not receive EA for 4 weeks. Body weight (BW) was monitored. Intraperitoneal glucose tolerance test and metabolic chamber recordings were performed. Blood samples and adipose tissue were collected for the analysis of leptin, triglyceride levels, and fat browning-related proteins. Results: EA significantly reduced food intake, BW, and white adipose tissue (WAT)/BW ratio; decreased the adipocyte size and serum concentrations of triglyceride (TG) and cholesterol; and increased oxygen consumption in HFD mice. Compared with the CD mice, the HFD mice had elevated fasting serum glucose level and impaired glucose tolerance; however, these parameters were decreased by EA treatment. Meanwhile, EA promoted the protein and mRNA expressions of UCP1, PRDM16, and PGC-1α in adipose tissue, and activated sympathetic nerves via p-TH, A2AR, and β3AR in white adipose tissue. Conclusions: EA reduced food intake, BW, TG, and cholesterol, and improved glucose tolerance in HFD mice. This ameliorative effect of EA on obesity-related symptoms associated with its promoted adipose tissue plasticity via activating sympathetic nerves.

Association of fasting serum glucose level and type 2 diabetes with hepatocellular carcinoma in men with chronic hepatitis B infection: A large cohort study

BackgroundIt is unclear whether elevated fasting serum glucose level and type 2 diabetes (T2DM) are associated with an increased risk of hepatocellular carcinoma (HCC), irrespective of obesity in patients with chronic hepatitis B. Patients and methodsOur study population comprised 214,167 Korean men with chronic hepatitis B in the National Health Insurance Service (NHIS) database between January 2002 and December 2006. Data on new events of HCC were obtained by records of the NHIS during the follow-up. We used Cox proportional hazards models adjusted for sociodemographic, lifestyle, health status and clinical conditions to estimate the hazard ratio (HR) and 95% confidence intervals (95% CIs) of HCC associated with different categories of fasting serum glucose level and T2DM, using fasting serum glucose <90 mg/dL as reference. ResultsDuring the 8 years of follow-up, there were 11,241 HCCs in men with chronic hepatitis B. Compared with the reference group, fasting serum glucose level of more than 140 mg/dL (HR = 1.46; 95% CI: 1.36–1.57; p < 0.001) and presence of T2DM (HR = 1.23; 95% CI: 1.15–1.34; p < 0.001) were associated with an increased risk of HCC after controlling for potential confounders. Significant association with fasting serum glucose and HCC was found for both non-obese (<25 kg/m2) and obese (≥25.0 kg/m2) patients (Ptrend < 0.001). ConclusionIn this cohort of men with chronic hepatitis B infection, elevated fasting serum glucose level and T2DM were significantly associated with an increased risk of HCC, regardless of obesity. Glycaemic control in men with chronic hepatitis B patients should be considered in clinical practice to prevent HCC.

Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders.

Corante, Noemí, Cecilia Anza-Ramírez, Rómulo Figueroa-Mujíca, José Luis Macarlupú, Gustavo Vizcardo-Galindo, Grzegorz Bilo, Gianfranco Parati, Jorge L. Gamboa, Fabiola León-Velarde, and Francisco C. Villafuerte. Excessive erythrocytosis and cardiovascular risk in Andean highlanders. High Alt Med Biol. 19:221–231, 2018.—Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb ≥21 g/dL in men, Hb ≥19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340 m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20%) in highlanders with EE was 3.63 times the odds in HH (CI 95%:1.22–10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.

Effect of elevated fasting serum glucose after smoking cessation on cardiovascular disease and mortality: an eight-year longitudinal study

Effect of elevated fasting serum glucose after smoking cessation on cardiovascular disease and mortality: an eight-year longitudinal study

Sociodemographic Factors, Health Behaviors, and Biological Indicators Associated With Suicide Mortality Among Young Adults in South Korea: A Nationwide Cohort Study Among 16 Million Men and Women

Background: The role of sociodemographic factors, health behaviors, and biological indicators as potential risk factors for suicide is relatively understudied among young adults. The aim of this study is to determine the association of sociodemographic factors, health behaviors, and biological indicators on the risk of death from suicide among young adults. Methods and Findings: The study population consisted of 16,277,532 individuals aged 20-39 years from the Korean National Health Insurance Service. Sociodemographic factors, determined at 2005, associated with death from suicide during 2006-2015 were evaluated. Furthermore, 2,055,789 individuals who underwent health examinations between 2002-2005 were separately assessed for health behaviors and biological indicators associated with death from suicide. Cox proportional hazards regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of death from suicide according to sociodemographic factors (age, household income, job status, residence, and Charlson comorbidity index), health behaviors (smoking, physical activity, and alcohol consumption), and biological indicators (body mass index, blood pressure, fasting serum glucose, and total cholesterol). Low household income, non-employment, increased comorbidity, smoking, and normal weight elevated the risk of death from suicide among young adults. While older age was associated with elevated risk for death from suicide among men, older age reduced the risk for death from suicide among women. Elevated blood pressure and fasting serum glucose were associated with increased risk for death from suicide among men. Finally, high total cholesterol levels were associated with increased risk for death from suicide among women. Conclusions: Sociodemographic factors, health behaviors, and biological indicators were associated with risk of death from suicide among young adults. The main limitation of our study is that we did not have data on family history of suicide or previous experience of suicidal attempts. Future studies that elucidate the mechanisms behind the risk elevating effect of such factors are needed to further validate the findings from our study. Funding Statement: This study was supported by the Ministry of Health and Welfare of Korea (Grant No: 20170322652-00). Declaration of Interests: The authors of this paper, Yoosun Cho, Seulggie Choi, Kyuwoong Kim, and Sang Min Park, declare that we have no conflict of interest. Ethics Approval Statement: This study was approved by the Seoul National University Hospital Institutional Review Board (IRB number: 1703-039-836) and the requirement for informed consent was waived as the NHIS database is anonymized according to strict confidentiality guidelines.

Prevalence and Risk Factors of Chronic Hepatitis B and C Virus Infection in the Immigrant Populations of the Twin Cities Metro Area, Minnesota, United States

Introduction: HBI-Minnesota is a non-profit organization that provides free viral hepatitis testing, screening for metabolic risk factors, education and linkages to care for underserved communities. Methods: Between February 2016 and April 2017, HBI-Minnesota screened 624 individuals in the Twin Cities (St. Paul and Minneapolis) for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Participants also underwent serum glucose and plasma cholesterol testing. Results: Mean age was 52 + 10 years. Majority (56%) were males, and 64% were foreign-born (17% Vietnam, 17% Laos, 8% Burma, 22% Africa, and 36% others). A total of 4.2% of participants had evidence of chronic HBV. A total of 43% had no evidence of immunity against HBV and should be vaccinated. A total of 1.4% have positive HCV antibody. Table-1 summarizes risk factors of positive HBV or HCV testing. Elevated fasting serum glucose (>110 mg/dL) was seen in 7.8%, while 12.3% had elevated total cholesterol (>190 mg/dL).Table: Table. HBI-Minnesota Screening for Liver Disease summary descriptives table by groups of ‘Hepatitis'Conclusion: HBV and HCV infections are prevalent in the immigrant populations in the Twin Cities Metro Area of Minnesota. Education about viral hepatitis testing and vaccination should be encouraged and supported.

High serum selenium levels are associated with impaired fasting glucose and elevated fasting serum glucose in Linyi, China

BackgroundThe relationship between selenium level and impaired fasting glucose or elevated fasting serum glucose remains controversial. This study aimed to evaluate these associations in China. MethodsThis observational population study adopted a cluster sampling approach to enroll participants. Baseline information on selenium categories was tested using one-way analysis of variance and Kruskal–Wallis equality-of-populations rank tests. Multivariable logistic regression was used to investigate the association between serum selenium level and impaired fasting glucose or elevated fasting serum glucose. ResultsThe mean serum selenium concentration was 121.5μg/L which in a relatively high baseline Se status. Differences were observed among individuals with normal, impaired fasting glucose and elevated fasting serum glucose levels in their basic information, physical examination results and laboratory findings. After adjusting for their basic information, physical examination results and laboratory findings, compared with the low-selenium group, the high-selenium groups (124.9–143.9 and above 143.9μg/L) had ORs for elevated fasting serum glucose of 2.31 (1.37–3.90) and 2.67 (1.59–4.48), respectively (both P<0.05). A sex-difference was observed, and a significant association between selenium levels and impaired fasting glucose was observed for males but not for females. ConclusionsThe findings of this observational study suggest that relatively high selenium levels might be positively associated with elevated fasting serum glucose and relatively high selenium levels might be positively associated with impaired fasting glucose in men.

The Fasting Serum Insulin and Glucose Levels and the Estimated Insulin Resistance in Clinical and Subclinical Hyperthyroid Patients from Saudi Arabia

Introduction: Hyperthyroidism is associated with insulin resistance, whereas its effect on pancreatic insulin secretion is controversial. The present study was aimed to investigate the influence of hyperthyroidism on the insulin availability and sensitivity and their correlations with the thyroid hormones in patients from Hail region in Saudi Arabia. Material and methods: The study was conducted on patients with thyroid disorders who were visiting the Diabetic and Endocrinology Unit of King Khalid Hospital, Hail, Saudi Arabia between April 2015 and July 2015. A total of 43 newly diagnosed hyperthyroid patients (age range: 18-77 years) were classified into: • Subclinical hyperthyroid (SHR) group: with serum TSH 25.0 pmol/L • Control (C) group of normal subjects Results: The fasting serum insulin levels in the SHR and OHR groups were severely raised by 6.22-fold and 7.67-fold, and the serum glucose by 28.76% and 54.79%, respectively compared to control, whereas, the kidney function was not altered in any of the groups. On the other hand, there were significant correlations between TSH and insulin levels (r=-0.79, P=0.0001), FT4 and insulin (r=0.34, P=0.03), TSH and insulin resistance (r =-0.5, P=0.001) and between TSH and insulin sensitivity index (r=0.90, P=0.000). Conclusion: Both clinical and subclinical hyperthyroid patients had significantly elevated fasting serum insulin and glucose levels and increased insulin resistance. Significant correlations exist between TSH and T4 with insulin levels, and between TSH with insulin resistance. The hyperthyroidism had no detrimental effects on the renal function.

Rice bran protein hydrolysates attenuate diabetic nephropathy in diabetic animal model.

Diabetic nephropathy (DN) is an important microvascular complication of uncontrolled diabetes. The features of DN include albuminuria, extracellular matrix alterations, and progressive renal insufficiency. Rice bran protein hydrolysates (RBPs) have been reported to have antihyperglycemic, lipid-lowering, and anti-inflammatory effects in diabetic rats. Our study was to investigate the renoprotective effects of RBP in diabetic animals and mesangial cultured cells. Eight-week-old male db/m and db/db mice were orally treated with tap water or RBP (100 or 500mg/kg/day) for 8weeks. At the end of the experiment, diabetic nephropathy in kidney tissues was investigated for histological, ultrastructural, and clinical chemistry changes, and biomarkers of angiogenesis, fibrosis, inflammation, and antioxidant in kidney were analyzed by Western blotting. Protection against proangiogenic proteins and induction of cytoprotection by RBP in cultured mesangial cells was evaluated. RBP treatment improved insulin sensitivity, decreased elevated fasting serum glucose levels, and improved serum lipid levels and urinary albumin/creatinine ratios in diabetic mice. RBP ameliorated the decreases in podocyte slit pore numbers, thickening of glomerular basement membranes, and mesangial matrix expansion and suppressed elevation of MCP-1, ICAM-1, HIF-1α, VEGF, TGF-β, p-Smad2/3, and type IV collagen expression. Moreover, RBP restored suppressed antioxidant Nrf2 and HO-1 expression. In cultured mesangial cells, RBP inhibited high glucose-induced angiogenic protein expression and induced the expression of Nrf2 and HO-1. RBP attenuates the progression of diabetic nephropathy and restored renal function by suppressing the expression of proangiogenic and profibrotic proteins, inhibiting proinflammatory mediators, and restoring the antioxidant and cytoprotective system.

Effect on Fasting Serum Glucose Levels of Adding Ezetimibe to Statins in Patients With Nondiabetic Hypercholesterolemia

Statin therapy is associated with a slightly increased risk of developing diabetes mellitus and insulin resistance in patients without diabetes. Ezetimibe combined with statins may be considered for high-risk patients who do not achieve optimal low-density lipoprotein cholesterol lowering on statin monotherapy or who are statin intolerant. Changes in fasting serum glucose (FSG) levels during ezetimibe, ezetimibe/statin, and statin treatments were assessed using data pooled from clinical trials in hypercholesterolemic and heterozygous familial hypercholesterolemic patients, who were or were not receiving statin therapy. Study types included first-line trials in statin-naive/wash-out patients and second-line add-on and uptitration studies in patients on stable statin therapy. Similar analyses of FSG changes were performed separately for each study type in patients who were nondiabetic at baseline. Across all study types and treatments, mean FSG increases from baseline were small (0.5 to 3.7mg/dl with ezetimibe/statin; 0.2 to 4.6mg/dl with statins) and decreased over time; between-treatment differences (0.3 to 1.4mg/dl) were nonsignificant for all comparisons. Proportions of patients with elevated FSG ≥126mg/dl during therapy were low and similar for all treatments in the overall cohort (1.2% to 4.3%). Elevations were highest (3.3% to 25.7%) among patients with baseline factors characteristic of metabolic syndrome and prediabetes, including higher FSG, body mass index, and triglyceride levels, and numerically lower baseline high-density lipoprotein cholesterol; however, these factors were not related to FSG increases. Changes in low-density lipoprotein cholesterol, body mass index, high-density lipoprotein cholesterol, triglycerides, and apolipoprotein B were not significantly correlated with FSG increases. In conclusion, statin therapy was associated with small FSG increases, and the addition of ezetimibe did not further increase FSG levels beyond those of statins when given to patients who are statin naive or those on statin therapy.

Physiological characteristics of patients with schizophrenia prematurely dying from circulatory diseases.

Patients with schizophrenia before reaching geriatric age are at high risk of circulatory mortality. However, investigations are lacking on the characteristics of physiological measurement among these at-risk patients. In this study, we followed acutely inpatients with schizophrenia disorder for cause of death through record linkage to the Death Certification System in Taiwan. Cases of patients who died because of circulatory morbidity (ICD-9 401-443) before turning 65 years old were used. Each schizophrenia case was then matched with two mentally healthy controls for the age and sex, and date of laboratory examination. Clinical data of all subjects were obtained by reviewing medical records. Totally, 81 patients with schizophrenia who died from circulatory diseases at mean ages of 48.0 ± 10.7 years were investigated. The mean age at the final acute psychiatric hospitalization was 43.0 ± 10.9 years. Multivariate analysis showed that elevated fasting serum glucose levels (95% confidence interval [CI] for odds ratio (OR) = 1.00-1.03), blood leukocyte counts (95% CI for odds ratio (OR) = 1.07-1.55), and heart rates on electrocardiogram (95% CI for OR = 1.04-1.10) in the final psychiatric hospitalization collectively provided the predictive validity for premature circulatory death. Systemic inflammatory activation and autonomic nervous system dysfunction along with dysregulation of glucose metabolism rather than lipids could be the physiological characteristics of schizophrenia patients at risk of premature circulatory mortality.

Arterial stiffness and endothelial inflammation in prediabetes and newly diagnosed diabetes patients.

There is a growing body of data supporting the association between diabetes and microcirculatory disfunction. We aimed to study e-selectin levels, and their associations with serum markers of inflammation and arterial stiffness in prediabetes and newly diagnosed diabetes patients in this study. Sixty patients (25 females) with a newly established elevated fasting serum glucose [20 impaired fasting glucose (IFG), 20 impaired glucose tolerance (IGT), 20 newly diagnosed diabetes (T2DM)] and 17 healthy controls (13 females) were included in the study. Serum e-selectin and hs-CRP levels, and arterial stiffness parameters of the patients were studied. Fasting serum glucose was the most important predictor of serum e-selectin levels. Pulse wave velocity and central aortic pressures were significantly higher in IFG, IGT and T2DM groups, compared to controls (p = 0.001, < 0.001, 0.013 and 0.015, 0.002, 0.009, respectively). The mean arterial pressure did not show any significant association with serum e-selectin and hs-CRP levels (β coefficient: 0.092, p = 0.358; and β coefficient: 0.189, p = 0.362, respectively). Prediabetes patients have increasing e-selectin levels through the diagnosis of T2DM. E-selectin is associated with serum glucose levels. Prediabetic and newly diagnosed diabetics have higher arterial stiffness measurements. Serum e-selectin may be a good marker of endothelial inflammation and dysfunction increasing in parallel with serum glucose levels, predicting future cardiovascular events.

Problems of using Hydrochlorothiazide Diuretic in Adult Diabeti c Patient in Diabetic Clinic of Adama Hospital Medical College, E ast Shoa Zone, Oromia Regional State, Ethiopia

Background: Diabetes Mellitus (DM) is a group of common metabolic disorders that share the phenotype of hyperglycemia. Half century ago hydrochlorothiazide has been associated with a diagnosis of diabetes in hypertension treatment containing hydrochlorothiazide during long term therapy. This explained by association between glucose, potassium, and hydrochlorothiazide induced hyperglycemias and plasma insulin level. The objective of this study was to assess the problem associated with use of hydrochlorothiazide among adult diabetic patient in diabetic clinic of AHMC. Methodology: A cross sectional study was carried out by reviewing patient information sheet and physician diagnosis card with a period from March, 25-May, 28, 2014. Data was collected from patient information sheet and physician diagnosis card by using check list and collected data was analyzing by using SPSS-20. Result: In this study population the total of 1,200 patient cards with hypertension and type-2 diabetes were observed, from which only 60 patient have a problem associated with hydrochlorothiazide diuretic. Among these patient 55% were female and 38.3% were in the age group of 40-50 years and mean age was 51 years. Most of patient, 82% patient had increased FBS after HCT administration and around 90% of patient had decreased FBS after HCT discontinuation. Among the total number of the cases only in 5% showed high response to insulin and 37% low response to insulin. Most of the patient around 70% develop problem associated with HCT within start to six month. Conclusion: In general in this study indicated that elevated fasting serum glucose level was the main problem associated with the use of HCT in adult diabetic patient