Fasting Glycemia Research Articles

Impact of Sleeve Gastrectomy on Body Weight and Food Intake Regulation in Diet-Induced Obese Mice

The epidemic of obesity has increased worldwide and is associated with comorbidities such as diabetes and cardiovascular disease. In this context, strategies that modulate body weight and improve glycemic metabolism have increased, and bariatric surgeries such as Sleeve Gastrectomy (SG) have been highlighted in obesity treatment. However, the mechanism by which SG reduces body weight and improves glycemic control remains unknown. Thus, in this study, we aimed to evaluate food intake and the expression of hypothalamic genes involved with the regulation of this process in diet-induced obese mice submitted to SG. For this, we used C57BL/6 mice submitted to a 10-week high-fat diet protocol and submitted to SG. Food intake, fed and fasted glycemia, as well as hypothalamic anorexigenic and orexigenic gene expression were evaluated 4 weeks after the surgical procedure. First, we observed that SG reduces body weight (44.19 ± 0.47 HFD, 43.51 ± 0.71 HFD-SHAM, and 38.22 ± 1.31 HFD-SG), fasting glycemia (115.0 ± 4.60 HFD, 122.4 ± 3.48 HFD-SHAM, and 93.43 ± 4.67 HFD-SG), insulinemia (1.77 ± 0.15 HFD, 1.92 ± 0.27 HFD-SHAM, and 0.93 ± 0.05 HFD-SG), and leptinemia (5.86 ± 1.38 HFD, 6.44 ± 1.51 HFD-SHAM, and 1.43 ± 0.35 HFD-SG) in obese mice. Additionally, SG reduces food (5.15 ± 0.18 HFD, 5.49 ± 0.32, HFD-SHAM, and 3.28 ± 0.26 HFD-SG) and total (16.88 ± 0.88 HFD, 17.05 ± 0.42, HFD-SHAM, and 14.30 ± 0.73 HFD-SG) calorie intake without alterations in anorexigenic and orexigenic gene expression. In conclusion, these data indicate that SG improves obesity-associated alterations at least in part by a reduction in food intake. This effect is not associated with the canonical food intake pathway in the hypothalamus, indicating the involvement of non-canonical pathways in this process.

Vector of glycated hemoglobin in the formation of dysglycemia in postmenopause: Emphasis on early diagnosis and therapy

Introduction. The close relationship of postmenopause with insulin resistance (IR) and metabolic syndrome (MetS) marks a high cardiometabolic risk of dysglycemia, determining the need for its early diagnosis and therapy. Pathogenetically substantiated criteria for the diagnosis of prediabetes and the nature of early drug therapy for type 2 diabetes mellitus (T2DM) are debated. Information on the relationship between glucose homeostasis parameters and menopausal MetS is fragmentary.Aim. To evaluate the associations of glycated hemoglobin (HbA1c) levels with indices of IR, β-cell function and MetS character- istics in a cohort of postmenopausal women with different carbohydrate metabolic states.Materials and methods. In 94 Caucasian postmenopausal women 58.0 (53.0; 63.0) years old the following were determined: HbA1c, fasting glycemia (FG), TyG and HOMA2 indices, C-peptid, BMI, waist circumference (WC), blood pressure (BP), triglycerides (TG), HDL-C levels. When classifying women by HbA1c (ADA criteria), 15 had normoglycemia, 24 prediabetes, 55 T2DM. ME (25–75%) was assessed using SPSS (version 17); intergroup differences according to the Mann – Whitney test; Spearman and partial correlation analysis were performed.Results. HbA1c age independently correlated with IR parameters: TyG (R = 0.590; p < 0.001), HOMA2-IR (R = 0.318; p < 0.05) and beta cell function: HOMA2-B (R = -0.355; p < 0.001); with lipid markers of MetS (TG, HDL-C, respectively R = 0.382; -0.448; p < 0.001), anthropometric and blood pressure levels.Conclusion. Associations of HbA1c in postmenopausal women with a spectrum of glucose homeostasis parameters and MetS mark it as a vector of formation and progression of dysglycemia due to a close connection with the functional state of β-cells and the importance of lipoglucotoxicity in the dynamics of postmenopausal IR. The obtained data pathogenetically determine the use of HbA1c in the verification of dysglycemia and the early administration of combined antihyperglycemic therapy aimed at preserving β-cell function. The potential of dipeptidyl peptidase-4 inhibitors in slowing the progression of type 2 diabetes mellitus is considered

The effect of high-fibre diets on glycaemic control in women with diabetes in pregnancy: A systematic review and meta-analysis.

We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes. Data were pooled for each outcome to calculate change from baseline mean (SD) and overall mean difference (MD) between control and intervention groups. Of 1462 identified studies, data from 20 eligible trials containing 1061 participants were pooled. On meta-analysis, a higher fibre intake was associated with reduced FBG (MD: -0.35 mmol/L, 95% CI: -0.53, -0.18, p < 0.01), PBG (MD: -0.90 mmol/L, 95% CI: -1.39, -0.40, p < 0.01) and requirement for insulin (OR: 0.24, 95% CI: 0.13, 0.46, p < 0.01). There was significant heterogeneity for FBG and PBG (>90%), attributable to differences in Intervention type for PBG (Dietary Approach to Stop Hypertension [DASH] diet, low glycaemic index, supplement; p < 0.01) and study duration (for FBG: p = 0.002; not for PBG). Studies were mostly scored as high risk of bias due to lack of blinding (Cochrane Risk of Bias Tool v.2.0). High-quality dietary intervention studies in pregnancy are lacking. Our results suggest that high-fibre diets improve fasting and postprandial glycaemia and reduce the likelihood of requiring insulin in women with diabetes in pregnancy.

Factors associated with type 2 diabetes control in hard-to-reach communities in Esmeraldas, Ecuador

Abstract Background The rising prevalence of type 2 diabetes mellitus (T2DM) and its detrimental effects on population health make it an urgent public health concern. Maintaining blood glucose control is crucial for avoiding complications; however, there are notable socioeconomic disparities in disease management, especially in low- and middle-income settings. We aimed to examine the factors associated with controlled fasting capillary glucose in a difficult-to-access rural setting of Esmeraldas, Ecuador, and to examine the role of social support in this context. Methods Between October 2020 and May 2022, we conducted a cross-sectional study of T2DM adult patients in Esmeraldas’ Eloy Alfaro health district. We collected data on socio-demographic and clinical patient characteristics using a questionnaire and measured Fasting Capillary Blood Glucose levels. We estimated the prevalence of controlled glycaemia and used logistic regression to calculate odds ratios (OR) with 95% confidence intervals. Results Only 18.1% (95%CI: 14.9-21.8) of the 476 study participants had controlled glucose levels, with a significantly higher percentage in men (28.2%) compared to women (13.8%). Participants reported moderate perceived social support (median=2.33, on a scale of 1 to 4), without significant impact on glycaemic control. Women in urbanised areas were more likely to have controlled glucose levels compared to those in rural areas (aOR=2.34, 95%CI: 1.23-4.44) after adjusting for family support. In contrast, unemployed and older men had non-significant trends towards better odds of achieving controlled fasting glycaemia. Conclusions The complex interplay of factors affecting diabetes management and glycaemic control highlights the need for targeted, context and gender-specific public health strategies to address diabetes disparities in vulnerable populations. Key messages • The majority of individuals with T2DM residing in the remote communities of Eloy Alfaro district in Esmeraldas (Ecuador) have uncontrolled glycaemia, showing notable gender-specific disparities. • Participants reported a moderate level of social support, with family as the most important source. Yet, this perceived support may not effectively overcome contextual barriers in T2DM management.

Predicting non-responders to lifestyle intervention in prediabetes: a machine learning approach.

The clinical care process for people with prediabetes starts with lifestyle intervention, often escalating to more intense treatment due to the low success rate of the first-line intervention. Clinicians lack clear guidelines on which patients would benefit from early treatment with more intensive therapeutic options, so we aimed to develop an algorithm to early identify non-responders to lifestyle intervention for prediabetes. Several statistical and machine learning algorithms were screened with internal cross-validation on the basis of accuracy and discrimination ability to correctly classify patients that would fail to normalize fasting glycemia within one year of being prescribed a lifestyle intervention, solely based on the first examination measurements. Of the many screened algorithm, only a random forest model performed with sufficient accuracy to exceed the historical failure rate of patients within our center, with an accuracy of 0.689 (CI 0.669, 0.710) and an AUROC of 0.687 (CI 0.673, 0.701). This study showcases the ability of machine learning models to provide useful insight in clinical practice leveraging knowledge contained in routinely collected data.

7986 Cardiovascular Risk Factors in Patients with Autoimmune Thyroiditis: Impact of Overweight and Obesity

Abstract Disclosure: C. Neves: None. J. Neves: None. L. Pereira: None. O. Sokhatska: None. J. Queirós: None. J. Delgado: None. Background: Autoimmune thyroiditis is one of the most common organ specific autoimmune disorders. Several studies suggest that patients with autoimmune thyroid may have an increased cardiovascular risk even among those with normal thyroid function. Our objective was to evaluate the cardiovascular risk factors in autoimmune thyroiditis according to body weight. Methods: We evaluated patients with autoimmune thyroiditis followed in outpatient clinic. We evaluated anthropometric parameters, glycemic profile, lipid, homocysteine, folic acid, B12 vitamin, high-sensitivity C reactive protein (hsCRP), thyroid function and thyroid autoimmunity. Participants were divided in groups according to body weight: normal weight [body mass index (BMI) 18.5-24.9 kg/m2], overweight (BMI 25.0-29.9 kg/m2) and obesity (BMI ≥30 kg/m2). Correlations were evaluated in the whole group and in subgroups of body weight. Statistical analysis was performed with the one-way ANOVA test and Pearson’s correlation test. Results: Within our sample of 354 patients had autoimmune thyroid, 93.8% were females, with a mean age of 46.7±16.3 years. One-hundred and three (37.6%) had normal weight, 128 (36.1%) had overweight and 91 (25.7%) had obesity. The mean TSH level of our population was 2.5±6.0 μUI/L. In our sample, TSH, FT4 and FT3 did not significantly differed between body weight groups. Comparing with normal weight, patients with obesity and overweight had higher fasting glucose (normal weight 92±13 mg/dL vs overweight 91±23 mg/dL vs 92±13 mg/dL, p= 0.004), higher LDL levels (normal weight 112.7±29.2 mg/dL vs overweight 130.1±29.4 mg/dL vs obesity 130.6±31.3mg/dL, p&amp;lt;0.001), higher triglycerides (normal weight 94.8 ± 43.0 mg/dL vs overweight 120.1 ± 79.0 mg/dL vs obesity 140.5 ± 80.4 mg/dL, p&amp;lt;0.001) and higher hsCRP levels (normal weight 0.3±0.5 mg/dL, overweight 0.4±0.5 mg/dL vs obesity 0.5±0.6 mg/dL, p=0.018). In the whole group, TSH was positively correlated with insulin (r=0.184, p=0.003), C-peptide (r=0.187, p=0.003) and HOMA-IR (r=0.178, p=0.004); anti-TG was negatively correlated with HDL (r= -0.147, p=0.006), and anti-TPO was positively correlated with LDL cholesterol (r=0.134, p=0.013) and with HOMA-IR (r= 0.126, p=0.039). In patients with normal weight anti-TG was negatively correlated with fasting glycemia (r=-0.204, p=0.046). In patients with overweight, anti-TG was positively correlated with hsCRP (r= 0.187, p= 0.043). In patients with obesity, TSH was positively correlated with C-peptide (r=0.280, p=0.020) and triglycerides (r=0.258, p= 0.016); and anti-TPO was correlated with fasting insulin levels (r=0.282, p=0.018). Conclusions: In patients with autoimmune thyroiditis, the interrelationships between thyroid function, autoimmunity, obesity, insulin resistance and lipid profile may contribute to the increased cardiovascular risk. Presentation: 6/3/2024

Influence of the consumatory behavior onto the risk of obesity and its complications in primary school children

Objective. To identify the relationship of eating behavior and clinical and metabolic status of 6–11-year-old children in order to develop effective methods for prevention and treatment of obesity and its complications. Materials and methods. 94 children aged 6 to 11 participated in the research. They formed 2 groups: group I (n = 64) – obese children (standard deviation score (SDS) of body mass index (BMI) ≥ +2.0), group II (n = 30) – children with normal body weight (SDS BMI –1.0 … +1.0). Clinical and laboratory parameters were studied and eating behavior was assessed using the Child Eating Behavior Questionnaire. Results. As a result of the study, it was determined that average values of triglycerides (TG), uric acid (UA), thyroid-stimulating hormone (TSH), fasting glycemia (FG), p = 0.001, p = 0.002, p 0.001, p 0.001 were higher in obese children. The following features of the eating behavior in obese children have been revealed: a more active reaction to food and emotional overeating, p = 0.016, p = 0.004 Statistically significant direct moderate correlations between SDS BMI and the level of TG, UA, TSH and FG under the influence of eating behavior according to the “eating approach” type were established. Conclusions. An association between the pattern of eating behavior in obese children aged 6–11 and their clinical and metabolic status, which determines the risk of atherosclerosis and cardiovascular diseases in the future was revealed. The results obtained are a justification for identifying the nature of children`s eating behavior in order to prevent the development of obesity and associated complications, as well as to increase the effectiveness of therapy.

The relationship between iron metabolism markers and parameters of carbohydrate and lipid metabolism in patients with overweight and obesity

Background: Hyperferritinemia associated with obesity and insulin resistance is a link between the components of the metabolic syndrome and a possible triggering factor in the pathogenesis of carbohydrate metabolism disorders and dyslipidemia.Aim: To establish possible relationships between ferrokinetic parameters, parameters of lipid and carbohydrate metabolism in overweight and obese patients, and to analyze the possibility of using iron metabolism parameters (ferritin and serum iron) as predictors of carbohydrate metabolism disorders in this cohort of patients.Material and Methods. The study included 52 overweight or obese patients. In the course of the study, patients were stratified into groups depending on the presence of carbohydrate metabolism disorders (CMD), and depending on the state of iron metabolism. Among all patients included in the study, an assessment of anthropometric data, a study of glycated hemoglobin, a standard glucose tolerance test with 75 g of glucose, a study of hematological parameters, as well as biochemical parameters of iron metabolism – the concentration of serum iron, transferrin and ferritin, was carried out.Results. Patients with CMD – impaired glucose tolerance or impaired fasting glycaemia – had significantly higher serum ferritin levels than obese patients without CMD (p = 0.019). In persons with a high level of ferritin, CMD developed significantly more often than in patients with a ferritin content in the range below the 75th percentile (χ2 = 5.278, p = 0.022). According to the ROC analysis, ferritin showed a rather high sensitivity – 75%, and specificity – 84.4% at a diagnostic threshold of 126.65 ng/ml (area under the curve = 0.738; p = 0.016) in the diagnosis of prediabetes (IGT/IFG) in overweight and obese individuals.Conclusion. High concentrations of iron and ferritin are positively associated with CMD, with ferritin being a promising predictor of prediabetes and type 2 diabetes mellitus.

Preoperative Laparoscopic Sleeve Gastrectomy Improves Weight Loss Potential in Morbidly Obese Voluntary Kidney Donors

This was a retrospective study aimed at evaluating the efficacy of laparoscopic sleeve gastrectomy (LSG) as a strategy for weight loss in obese prospective voluntary kidney donors who were unable to achieve weight reduction through lifestyle changes. This retrospective study included living kidney donors who underwent LSG as a strategy for weight loss in obese prospective voluntary kidney donors between 2012 and 2022. Prospective donors who were initially rejected due to obesity underwent LSG after pretransplantation evaluation. Changes in weight, body mass index (BMI), and laboratory parameters (hemogram, kidney function tests, liver function tests, fasting and postprandial glycemia, HbA1c, and lipid profile measurements) were recorded before bariatric surgery and before nephrectomy. Of the 16 candidates who underwent LSG, one did not proceed with donor nephrectomy due to the intended recipient's death. Among the remaining 15 subjects, the average interval between bariatric surgery and donor nephrectomy was 165.95 ± 48.86 days. There was a significant decrease in BMI following bariatric surgery (P < .0001); the mean BMI before bariatric surgery was 40.94 ± 4.53 kg/m², and before nephrectomy, it was 30.91 ± 3.87 kg/m2. The mean weight loss was 22.64 ± 5.75 kg. This study supports LSG as an effective approach for obese individuals who are potential kidney donors to achieve weight loss, mitigate obesity-associated risks, and become successful kidney donors.

A multiorgan map of metabolic, signaling, and inflammatory pathways that coordinately control fasting glycemia in mice

A multiorgan map of metabolic, signaling, and inflammatory pathways that coordinately control fasting glycemia in mice

EFFECTIVENESS OF CONTINUOUS GLUCOSE MONITORING IN UNCONTROLLED TYPE-2 DIABETICS IN TERTIARY HEALTHCARE CENTRE

Long term diabetic complications can be prevented or reduced by achieving good metabolic control, reflected by HbA1c &lt;6.5–7.0%.1-3 Glucose excursions might also contribute to the development of diabetic complications.4,5 Fear of hypoglycemia limits the ability to reach strict glycemic control, because it is usually accompanied by reluctance of the patient to intensify insulin therapy. Indeed, the goal of intensive therapy is to normalize HbA1c and control fasting and postprandial glycemia, while concurrently limiting the number and severity of hypoglycemic events. To reach tight glycemic control, frequent self- monitoring of blood glucose (SMBG) must be performed.6 SMBG devices provide the patient with accurate but discreet blood glucose levels. They do not provide trend information nor do they reflect glycemic fluctuations, which is possible by using continuous glucose monitoring (CGM) systems. Thus, implementation of strict glycemic control may be facilitated by a CGM device. This manuscript critically reviews the proposed benefits and indications of CGM and the current evidence of CGM on health outcomes in diabetic patients.

Effects of Laser Acupuncture on Metabolic Functions of Sedentary People: A Double-Blind Randomized Clinical Trial.

Background: Laser acupuncture regulates energy flow and restores body fluid metabolism. Objective: To evaluate the effects of the laser acupuncture protocol (LAP) on hepatic and renal metabolism in sedentary people. Methods: Longitudinal, double-blind, and randomized clinical trial with 29 participants, adults, both sexes, sedentary, without pre-existing metabolic diseases, subdivided into control and laser groups. Based on the STandards for Reporting Interventions in Clinical Trials of Acupuncture 2010 guidelines, 10 laser applications (660 nm ±10 nm wavelength, 100 mW power. The irradiation tip has a diameter of 5 mm, which corresponds to an area of 0.19 cm2, totaling a power density of 0.52 W/cm2 and considering the irradiation time of 90 s, the energy density applied was 47.3 J/cm2) were performed on the acupoints of metabolic functions (LR3, SP6, ST36, and LI4) and blood samples were collected for fasting glycemia, lipid profile (HDL, LDL, total cholesterol, and triglycerides), liver function (AST/GOT and ALT/GPT), and renal function (serum creatinine and urea). A repeated measures analysis of variance (ANOVA) with Bonferroni corrected post hoc comparisons was applied to compare statistical differences between groups and times, adopting p < 0.05 as the null hypothesis. Results: The laser stimulated changes in serum lipid profile values and renal and hepatic functions. There was a significant (p = 0.014) reduction in LDL ("bad" cholesterol) from 105.75 ± 32.83 pre- to 84.32 ± 18.38 mg/dL postintervention, associated with cardioprotective function. Positive significant (p = 0.035) impacts were also observed in the reduction of creatinine (0.86 ± 0.12 mg/dL to 0.75 ± 0.12 mg/dL) and the enzyme AST/GOT (33.73 ± 12.95 U/L to 20.80 ± 4.99 U/L, p = 0.002). Conclusion: LAP applied to basal metabolism acupoints promoted positive metabolic changes in the lipid profile (LDL), and in main markers of the liver (AST/GOT) and kidney (creatinine) functions, contributing to risk control of cardiovascular diseases.

Mediterranean Diet Prior to Ischemic Stroke and Potential Circulating Mediators of Favorable Outcomes.

Background/Objectives. A Mediterranean diet (MD) has been associated with neuroprotective effects. We aimed to assess the MD's association with stroke prognosis and the potential mediators involved. Methods. Seventy patients with acute anterior circulation ischemic stroke were included. Dietary patterns were evaluated using the MEDAS scale, a food-frequency questionnaire, and a 24 h recall. Circulating biomarkers including insulin resistance (HOMA index), adipokines (resistin, adiponectin, leptin), choline pathway metabolites (TMAO, betaine, choline), and endothelial progenitor cells (EPCs) were measured. Early neurological improvement (ENI) at 24 h, final infarct volume, and functional outcome at 3 months were assessed. Results. Adherence to MD and olive oil consumption were associated with a lower prevalence of diabetes and atherothrombotic stroke, and with lower levels of fasting glycemia, hemoglobinA1C, insulin resistance, and TMAO levels. Monounsaturated fatty acids and oleic acid consumption correlated with lower resistin levels, while olive oil consumption was significantly associated with EPC mobilization. Multivariate analysis showed that higher MD adherence was independently associated with ENI and good functional prognosis at 3 months. EPC mobilization, lower HOMA levels, and lower resistin levels were associated with ENI, a smaller infarct volume, and good functional outcome. Conclusions. MD was associated with better prognosis after ischemic stroke, potentially mediated by lower insulin resistance, increased EPC mobilization, and lower resistin levels, among other factors.

A Glycemic Threshold Above Which the Improvement of β-Cell Function and Glycemia in Response to Insulin Therapy Is Amplified in Early Type 2 Diabetes: The Reversal of Glucotoxicity.

Alleviation of unrecognized glucotoxicity, with resultant recovery of β-cell function, could amplify the glucose-lowering effect of pharmacotherapy and contribute to the variable therapeutic response observed among patients with type 2 diabetes (T2D). However, clinical evidence supporting this concept is lacking. Short-term intensive insulin therapy (IIT) can ameliorate glucotoxicity and improve β-cell function in early T2D. Thus, for evidence of recovery of glucotoxicity-associated β-cell dysfunction, we sought to determine whether there exists a baseline fasting glucose threshold above which the post-IIT improvement in both β-cell function and glycemia is amplified. IIT (glargine, lispro) was administered for 3 weeks to 108 adults with T2D (mean duration 1.8 ± 1.4 years). Oral glucose tolerance tests before and after IIT enabled assessment of β-cell function by Insulin Secretion-Sensitivity Index-2 and insulinogenic index/HOMA-insulin resistance. For each level of baseline fasting glycemia from 6.0 to 10.5 mmol/L, we modeled the difference in IIT-induced percentage change in β-cell function between those at/above the indicated glucose level and those below it. The relationship between baseline fasting glucose and the differential change in β-cell function was nonlinear. Instead, this relationship was best fit by a cubic regression model with inflection (amplification) at fasting glucose at 9.3 mmol/L. Moreover, baseline fasting glucose at 9.3 mmol/L also identified the inflection point at which nonlinear reductions in fasting glucose and 2-h glucose, respectively, were both amplified. The respective improvements in β-cell function and glycemia in response to short-term IIT are amplified in those in whom baseline fasting glucose exceeds a defined threshold, consistent with reversal of glucotoxicity.

The Association of Glycated Hemoglobin and Lipid Profile with Peripheral Artery Disease in Metabolic Syndrome Patients from Northwestern Algeria

تم إدماج الهيموجلوبين السكري (Hb1Ac) كمؤشر لخلل السكر في الدم بدلا من غلوكوز الدم الصائم (FGB)، لتصنيف المرضى بناء على حوادث الأوعية الدموية ،حيث يرتبطHb1Acارتباطا وثيقا بعوامل الأوعية الدموية مثل سرعة موجة النبض وسمك الوسائط الداخلية، نسبة الألبومين / الكرياتينين (ACR) ومع ذلك فإن العلاقة بينHb1Acونسبة الدهون في تطور أمراض الشرايين لاتزال غير مؤكدة. هدفنا الرئيسي من هذه الدراسة هو التحقيق في ارتباطHb1Acونسبة الدهون مع أمراض الأوعية الدموية الطرفية (PAD) في المرضى الذين يعانون من الاضطراب الأيضي (MetS) في شمال غرب الجزائر. أجريت دراستنا المقطعية لمدة ستة أشهر. تم حساب مؤثر كتلة الجسم كالتالي: (BMI (kg/m²)=weight(kg)/height²(m²، تم استخدام مؤشر الكاحل والعضد (ABI) أقل من 0.9 وتصوير الأوعية لتشخيص PADوحددنا MetS وفقا لمعاييرNECP-ATPIII. تم استعمال اختبار تحليل الارتباط (correlation test) والانحدار الخطي (linear regression) لدراسة الصلة بينHb1Ac، نسبة السكر في الدم، نسب الدهون وحدوث أمراض الشرايين الطرفية لدى الأفراد المصابين بالاضطراب الأيضي. من بين 300 مصاب الاضطراب الأيضي، 53 % تمثل الذكور. لوحظ وجود ارتباطات إيجابية بينHb1Ac،(r=0.753, p&lt;0.001) FGB والتري غلسيريد ((TG (r=0.288, p&lt;0.001) وارتباط سلبي مع البروتين الدهني عالي الكثافة (HDL) (r=-0.356, p&lt;0.001). لم يظهرHb1Ac أي ارتباط مع الكوليسترول الكلي (TC) و البروتين الدهني منخفض الكثافة (LDL). أظهرت نسب الدهون(TG/HDL ,LDL/HDL , TC/HDL) ارتباطات ايجابية مع)Hb1Acr=0.332 r=0.232, r=0.43.(أكد اختبار الانحدار الخطي هذه النتائج. أظهر Hb1Ac ارتباطات ايجابية مع FGB و TG في حين أنه يرتبط سلبا بالبروتين الدهني عالي الكثافة(HDL) . و مستقل عن البروتين الدهني منخفض الكثافة (LDL) والكوليسترول الكلي (TC) و الجدير بالذكر أن نسب الدهون الثلاثة TG/HDL) LDL/HDL , TC/HDL (أظهرت ارتباطات ايجابية معHb1Ac .

P054 REDUCTION OF BLOOD PRESSURE AND CARDIOVASCULAR RISK WITH IMPROVEMENT OF GLUCOSE AND LIPID METABOLISM BY A NUTRACEUTICAL BASED IN MULBERRY LEAF AND FENUGREEK IN SUBJECTS WITH PREDIABETES

Background and Objective: In Spain there are &gt;5000000 prediabetic subjects, of which &gt;500000 develop type 2 diabetes annually. Alpha-glucosidase inhibitors such as acarbose have been shown to prevent type 2 diabetes and reduce blood pressure, development of hypertension and cardiovascular risk. White mulberry (Morus alba) leaves contain 1-deoxynojirimycin, a powerful competitive alpha-glucosidase inhibitor. A nutraceutical containing Reducose (standardized white mulberry leaf extract), fenugreek (Trigonella foenum-graecum, an AMP-kinase activator), inuline (soluble fiber), Lactiplantibacillus plantarum (probiotic), niacin (vitamin B3), chromium and zinc (oligoelements) has been developed for use in patients with prediabetes. We endeavored to study its tolerability and efficacy on the metabolic profile, blood pressure and cardiovascular risk of the patients, with the change in the HOMA2-IR index of insulin resistance (as a proxy for the risk of developing type 2 diabetes) as the main outcome. Methods: In this ongoing open study, adult patients with prediabetes have been recruited to receive the mentioned nutraceutical daily for 6 months with an intermediate visit after 3 months. BMI, blood pressure, fasting glucose, insulin, lipid profile and HOMA2-IR were determined at each visit. Results: Of 94 recruited patients, 37 have completed the second visit. The HOMA-2 IR dropped by 21.5% (p=0.0016), the cardiovascular risk estimated by SCORE2 by 14.6% (p=0.0009), fasting glycemia by 7.6 mg/dL (p=0.0005), HbA1c by 0.22% (p&lt;0.0001), non-HDL cholesterol by 12.4 mg/dL (p=0.0037), systolic blood pressure by 6.3 mmHg (p=0.0001), diastolic blood pressure by 5.2 mmHg (p=0.0236); the body weight and BMI did not change significantly, and there were no withdrawals due to adverse effects or serious tolerance issues. Conclusions: This nutraceutical was well tolerated and improved the metabolic (both glycemic and lipidic) profile, the blood pressure and the cardiovascular risk of patients with prediabetes. At present there are no licensed drugs for prediabetes in Spain, but this nutraceutical may be an option for these patients in combination with lifestyle changes.

Consumption of a Sourdough-Leavened Croissant Enriched with a Blend of Fibers Influences Fasting Blood Glucose in a Randomized Controlled Trial in Healthy Subjects

BackgroundAn incorrect lifestyle, including diet, is responsible for the worldwide dramatic increase in obesity and type 2 diabetes. Increasing dietary fiber consumption may lead to health benefits, and reformulation of bakery products may be a strategy to globally improve the diet. ObjectivesThis study aimed to assess the impact of a 2-wk breakfast consumption with a sourdough-leavened croissant containing a blend of dietary fiber from 10 sources (4.8 g/100 g, croissant enriched with dietary fibers [FIBCRO]), compared with a control croissant (dietary fibers 1.3 g/100 g, CONCRO) on daily energy intake, appetite, metabolic variables, and the gut microbiome. MethodsThirty-two healthy participants were randomly allocated to 2 groups consuming FIBCRO or CONCRO. Participants self-recorded their diet and appetite through 7-d weighted food diaries and visual analog scales every day over the 2 wk. At baseline and after the intervention, fasting blood and urine samples, and fecal samples were collected beside blood pressure, anthropometry, and body composition. Serum glucose, lipids, C-reactive protein, and insulin according to the official methods and serum dipeptidyl peptidase-4 (DPPIV) activity by photometric method were measured. Polyphenols and urolithins in urines were analyzed by Liquid chromatography–tandem mass spectrometry (LC/MS/MS), whereas gut microbiome in feces by shotgun metagenomics. ResultsFIBCRO consumption improved fasting blood glucose compared with CONCRO (mean changes from baseline −2.0 mg/dL in FIBCRO compared with +3.1 mg/dL in CONCRO, P = 0.022), also reducing serum DPPIV activity by 1.7 IU/L (P = 0.01) and increasing urinary excretion of urolithin A-sulfate by 6.9 ng/mg creatinine (P = 0.04) compared with baseline. No further changes in any of the monitored variables or in the gut microbiome were detected. ConclusionsResults suggested that a 2-wk consumption of a sourdough croissant claimed as “source of dietary fiber” improved fasting glycemia compared with a conventional sourdough croissant in healthy subjects. The reduced serum DPPIV activity and increased bioavailability of urolithin likely contributed to determine that effect independently from gut microbiome changes.This trial was registered at clinicaltrials.gov as NCT04999280.

Associations of adipose insulin resistance index with pancreatic β cell function (inverse) and glucose excursion (positive) in young Japanese women

The relationship of adipose tissue insulin resistance (AT-IR, a product of fasting insulin and free fatty acids) and homeostasis-model assessment-insulin resistance (HOMA-IR) to β-cell function was studied cross-sectionally in the setting of subtle glucose dysregulation. Associations of AT-IR and HOMA-IR with fasting and post-glucose glycemia and β-cell function inferred from serum insulin kinetics during a 75 g oral glucose tolerance test were studied in 168 young female Japanese students. β-cell function was evaluated by disposition index calculated as a product of the insulinogenic index (IGI) and Matsuda index. AT-IR, not HOMA-IR, showed positive associations with post-glucose glycemia and area under the glucose response curve although both indices were associated with fasting glycemia. HOMA-IR, not AT-IR, was associated positively with log IGI whereas both indices were inversely associated with Matsuda index. AT-IR, not HOMA-IR, showed inverse associations with log disposition index. Associations of adipose tissue insulin resistance with β-cell function (inverse) and glucose excursion in young Japanese women may suggest that lipotoxicity to pancreatic β-cells for decades may be associated with β cell dysfunction found in Japanese patients with type 2 diabetes. Positive association of HOMA-IR with insulinogenic index may be associated with compensatory increased insulin secretion.

Impact of prenatal THC exposure on lipid metabolism and microbiota composition in rat offspring

ObjectiveRecent studies have demonstrated that prenatal exposure to the psychoactive ingredient of cannabis that is tetrahydrocannabinol (THC) disrupts fatty acid (FA) signaling pathways in the developing brain, potentially linking to psychopathologic consequences. Our research aims to investigate whether changes in midbrain FA metabolism are linked to modifications in peripheral metabolism of FAs and shifts in microbiota composition. MethodsIn order to model prenatal exposure to THC (PTE) in rats, Sprague Dawley dams were systemically administered with THC (2 mg/kg, s.c.) or vehicle once daily from gestational day 5–20. To evaluate the metabolic impact of PTE in the offspring during preadolescence (postnatal day, PND, 25–28), we analyzed FA profiles and their bioactive metabolites in liver and midbrain tissues, and microbiota alterations. ResultsOur findings indicate that PTE leads to sex-specific metabolic changes. In both sexes, PTE resulted in increased liver de novo lipogenesis (DNL) and alterations in FA profiles, as well as changes in N-acylethanolamines (NAEs), ligands of peroxisome proliferator-activated receptor alpha (PPAR-α). In females only, PTE influenced gene expression of PPAR-α and fibroblast growth factor 21 (Fgf21). In male offspring only, PTE was associated with significantly reduced fasting glycaemia and with alterations in the levels of midbrain NAEs. Our analysis of the progeny gut microbiota revealed sex-dependent effects of PTE, notably an increased abundance of Ileibacterium in PTE-exposed male offspring, a change previously associated with the long-term effects of a maternal unbalanced diet. ConclusionsOur data suggest that in male PTE offspring a reduced fasting glycaemia, resulting from increased liver DNL and the absence of a compensatory effect by Ppar-α and FGF21 on glycemic homeostasis, are associated to alterations in midbrain NAEs ligands of PPAR-α. These metabolic changes within the midbrain, along with Ileibacterium abundance, may partly elucidate the heightened susceptibility to psychopathologic conditions previously observed in male offspring following PTE.

The diabetic parkinsonian – the association of diabetes mellitus comorbidity and symptoms of Parkinson’s disease

Introduction and objective: Many studies have investigated the interplay between Parkinson’s disease and diabetes mellitus, suggesting that glucose metabolism impairment may worsen the clinical course of Parkinson’s disease. This study aimed to explore the association between diabetes mellitus and the course of Parkinson’s disease. Materials and methods: A retrospective study was performed by analysing the clinical data of patients diagnosed with Parkinson’s disease who were hospitalised in University Clinical Centre of the Medical University of Silesia from 2019 to 2021. The study group comprised 241 patients selected according to the study’s inclusion and exclusion criteria. Their clinical conditions were assessed using body mass index, the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), the Hoehn–Yahr scale, Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT) and Beck Depression Inventory (BDI). Data were collected on current anti-parkinsonian treatment, fasting glycaemia, lipid panel, and thyroid stimulating hormone, homocysteine and vitamin D3 levels. Results: The study group included 31 patients diagnosed with diabetes mellitus and 240 patients without glucose metabolism impairment. Both groups were matched by considering age, disease duration, and gender distribution. Diabetic patients displayed a higher MDS-UPDRS part III OFF rating (42 [31–55] vs. 48 [39–59]; p = 0.0043), higher MDS-UPDRS part III ON rating (17 [11–26] vs. 26.5 [19–32]; p = 0.0009) and higher BDI score (7 [4–11] vs. 11 [9–16]; p = 0.0013). As expected, patients with diabetes mellitus had a higher fasting glycaemia, total cholesterol, lower high-density lipoprotein cholesterol and higher body mass index. Conclusions: Our study confirms the relationship between diabetes mellitus and a worse clinical course for Parkinson’s disease.