Higher Plasma Glucose Levels Research Articles

Clinical Characteristics of Fulminant Type 1 Diabetes Compared with Typical Type 1 Diabetes: One-Year Follow-Up Study from the Guangdong T1DM Translational Medicine Study.

BackgroundFulminant type l diabetes mellitus (FT1DM) is a subtype of type 1 diabetes mellitus (T1DM) with abrupt onset, but data on its progression was limited. This study was aimed at exploring the clinical features through one-year follow-up.Methods and MaterialsPatients with T1DM finishing at least one-year follow-up from June 2011 to July 2018 were enrolled from Guangdong Type 1 Diabetes Translational Medicine Study. Patients who fulfilled the respective criteria were categorized as an FT1DM group and a typical T1DM group (TT1DM). The 1 : 4 propensity score matching based on onset age, duration, and gender was performed between the FT1DM and TT1DM groups. Characteristics at the onset and after one-year follow-up were compared between the two groups.ResultsA total of 53 patients with FT1DM and 212 matched patients with TT1DM were included. At the onset, there was a shorter duration of symptomatic period before diagnosis observed in the FT1DM group than in the TT1DM group (2 [1, 7] vs. 30 [10, 60] days, P < 0.001). FT1DM patients had higher plasma glucose levels and higher percentage of diabetes ketoacidosis (P < 0.001, respectively). Both fasting and postprandial C-peptide levels (FCP and PCP, respectively) in FT1DM were significantly lower (P < 0.001). At enrollment, the duration of diabetes was 0.03 (0.00, 0.81) and 0.07 (0.00, 1.11) years and the level of HbA1c was 7.21 ± 1.56% and 10.06 ± 3.23% (P < 0.001) in the FT1DM and TT1DM groups, respectively. After one year, both FCP and PCP were still significantly lower in the FT1DM group (P < 0.001, 0.022) and the HbA1c level was similar between the two groups (P = 0.128). The level of HDL-C in FT1DM was significantly higher than that in the TT1DM group at enrollment (P = 0.019), and the change from enrollment was significantly greater than that in the FT1DM group (P = 0.042).ConclusionPatients with FT1DM had more severe metabolic derangement and deficiency of insulin secretion than patients with TT1DM at the onset, but glycaemic and metabolic control was not worse than that in TT1DM.

Effectiveness of Dose Adjustment of Insulin in Type 2 Diabetes among Hemodialysis Patients with End-Stage Renal Disease: A Randomized Crossover Study.

Determining insulin requirements for hemodialysis patients with end-stage renal disease (ESRD) is difficult. We performed a randomized crossover study among type 2 diabetes (T2DM) patients with ESRD on continuous hemodialysis and receiving standard insulin for glycemic control. The patients were randomized in 2 groups: daily insulin needed on the day after hemodialysis and a 25% decrease in daily insulin needed on the day after hemodialysis. A total of 51 T2DM patients with ESRD were enrolled. The adjusted-insulin group had higher plasma glucose levels at the 2nd hour of dialysis than those of the nonadjusted-insulin group. Incidence of hypoglycemia per dialysis session (3.3% vs. 0.7%, P = 0.02) and symptoms related to hypoglycemia (6.9% vs. 0.7%, P = 0.001) were more frequent in the nonadjusted-insulin group. A reduced insulin administration of 25% among T2DM patients undergoing hemodialysis on the day of dialysis was associated with sustained glycemic efficacy and the production of fewer hypoglycemic symptoms. This trial is registered with TCTR20180724002.

Shorter Telomere Length in Carriers of APOE-ε4 and High Plasma Concentration of Glucose, Glyoxal and Other Advanced Glycation End Products (AGEs).

Apolipoprotein-ε4 (APOE-ε4)-common variant is a major genetic risk factor for cognitive decline and Alzheimer's disease (AD). An accelerated rate of biological aging could contribute to this increased risk. Glycation of serum proteins due to excessive glucose and reactive oxygen species leads to the formation of advanced glycation end products (AGEs)-a risk factor for diabetes and AD, and decline in motor functioning in elderly adults. Aim of present study was to investigate impact of APOE-ε4 allele containing genotype and accumulation of AGEs in plasma on telomere length (TL). Results showed that TL is significantly shorter in APOE-ε4 carriers compared with non-APOE-ε4 carriers (p = .0003). Higher plasma glucose level was associated with shorter TL irrespective of APOE-ε4 allele containing genotype (r = -.26; p = .0004). With regard to AGEs, higher plasma glyoxal and fluorescent AGEs concentrations were inversely related to TL (r = -.16; p = .03; r = -.28; p = .0001), however, plasma Nε-(carboxymethyl)lysine levels didn't correlate with TL (r = -.04; p = .57). Results support the hypotheses that APOE-ε4 carriers have shorter telomeres than noncarriers and telomere erosion is increased with higher concentration of glucose, fluorescent AGEs, and glyoxal.

Predictors of Insulin Secretion in Japanese Patients with Histopathologically-confirmed Non-alcoholic Fatty Liver Disease.

Objective The correlation between the insulin secretion levels and the risk of hepatocarcinogenesis is clinically important. The aim of the present study was to determine the effects of various clinical parameters on C-peptide (CPR) levels in patients with non-alcoholic fatty liver disease (NAFLD). Methods In this retrospective cohort study, the effects of clinical parameters on insulin resistance (HOMA-IR) and insulin secretion levels (HOMA-β and fasting CPR) were investigated. Patients A total of 244 Japanese patients with histopathologically confirmed NAFLD were evaluated. Of these, 77 underwent the meal tolerance test (MTT) to evaluate the association of various clinical parameters with the CPR levels at 120 minutes. Results A multivariate analysis identified fasting plasma glucose (FPG) (≥110 mg/dL), aspartate aminotransferase (≥1.0×ULN IU/L), and a large waist circumference as independent predictors of insulin resistance (HOMA-IR ≥2.5) or high fasting CPR levels. Significant parameters for a low insulin secretion capacity (HOMA-β <30%) were not detected, except for the parameters mentioned in the diagnostic criteria of diabetes mellitus. Regarding the MTT, the CPR levels at 120 minutes were significantly higher in patients with fibrosis stage 3-4 than in those with stage 0-2. Body composition and genetic variation did not affect the CPR levels at 120 minutes. A multivariate analysis identified fibrosis stage (3-4), hyperuricemia, FPG (≥110 mg/dL), and procollagen III peptide (>1.0 U/mL) as independent predictors of high CPR levels at 120 minutes. Conclusion The present study showed that high plasma glucose levels and severe liver fibrosis stage influence insulin secretion levels in Japanese patients with NAFLD. Conservation of delayed insulin secretion levels was confirmed in patients with severe liver fibrosis.

Serum Secretogranin III Concentrations Were Increased in Subjects with Metabolic Syndrome and Independently Associated with Fasting Plasma Glucose Levels.

Secretogranin III (SCG3) plays a crucial role in the biogenesis of secretory granules in endocrine cells, and thus affects glucose homeostasis by regulating insulin secretion by pancreatic beta cells. Insulin resistance and compensatory hyperinsulinemia are hallmarks of metabolic syndrome (MetS). However, the role of SCG3 in MetS remains unclear. Therefore, we investigated the relationship between serum SCG3 levels and metabolic parameters in subjects with and without MetS. This was a case control study, and 295 subjects were recruited. Serum SCG3 concentrations were compared between groups. Associations between SCG3 levels and clinico-metabolic parameters were also examined. We found serum SCG3 levels were higher in the MetS group than non-MetS group (122.6 ± 79.2 vs. 90.6 ± 58.5 nmol/L, p = 0.009). Specifically, elevated SCG3 levels were found in subjects with high fasting plasma glucose (FPG) levels, central obesity, or hypertriglyceridemia. Additionally, MetS was an independent factor of serum SCG3 levels in multivariate linear regression analyses. Moreover, FPG, free fatty acids, and waist circumference were positively associated with serum SCG3 concentrations after adjusting for insulin levels, high-sensitivity C-reactive protein, and cardiovascular risk factors. In conclusion, serum SCG3 concentrations were higher in subjects with MetS and were independently associated with FPG levels.

Carbohydrate molecule size affects the metabolic and digestive dynamics of jundiá (Rhamdia quelen)

This experiment was conducted to study the effects of carbohydrates with different molecular sizes on growth performance, feed utilization and composition, activity of digestive enzymes, plasma and hepatic metabolites of jundia (Rhamdia quelen). Triplicate groups of jundia (4.08 ± 0.005 g) were stocked in 12 tanks with stocking density of 25 individuals per tank and fed for 40 days with four isonitrogenous diets (37%) and isocaloric diets (3,200 kcal/kg) containing fructose (FRU), sucrose (SUC), maltodextrin (MALDEX) or corn starch (CS). The results showed no significant differences for growth variables and digestive enzymes. Fish whose diet received maltodextrin showed higher levels of deposited body fat and hepatosomatic index. Moreover, the above‐mentioned treatment resulted in lower concentrations of glucose and cholesterol in the plasma of jundia, higher levels of triglycerides, and lower reserves of glucose and liver glycogen. However, fish fed the starch‐based diet presented higher moisture content, crude protein deposition, and body protein retention coefficient. In that same treatment, the jundia presented higher levels of plasma glucose and liver protein. In conclusion, the efficiency of using digestible carbohydrates in iso‐nutritional diets for jundia depends on the size of their molecular structure. The corn starch was the best dietary carbohydrate source for jundia, based on feed utilization and composition and greater synchronicity between energy utilization and protein synthesis.

Adaptation of the Andean Toad Rhinella spinulosa (Anura: Bufonidae) at Low Temperatures: The Role of Glucose as Cryoprotectant.

We studied the role of plasma glucose concentration on individuals of Rhinella spinulosa in response to annual temperature variation and freezing temperatures. Measurements and collection of toads were made every 2 mo for a period of 1 yr. To determine whether toads were exposed to low temperatures in their habitat, we proceeded with the study of operating temperatures (Te). The measures of operating temperature were determined by using plaster models placed in the field, simulating the situation where toads are outside or inside shelters, for which it was determined that individuals in the winter season would have been exposed to temperatures below 0°C. Glucose levels measured in field specimens showed an annual variation, but laboratory specimens exposed to freezing temperatures had higher plasma glucose levels than field toads. Furthermore, the crystallization temperature for the species has been recorded at -1.6°C. The increase in glucose concentration indicates its possible use as a cryoprotectant before freezing events in this species of frogs and also in the coldest months at temperatures below 0°C.

Role Of Pcsk9 On Pancreatic Function And Insulin Release; Evidence From Mice Models

Background and Aims: PCSK9 genetic polymorphisms are associated with lower LDL-Cholesterol levels but also with higher plasma glucose levels and increased risk of developing T2D. We investigated the molecular mechanisms beyond this association.

1976-P: Physiological Effects of GIP(1-30)NH2 in Healthy Subjects

The gut-derived incretin hormone glucose-dependent insulinotropic polypeptide (GIP) circulates in at least two active forms: GIP(1-42), which besides its insulinotropic effect during hyperglycemia stimulates glucagon secretion at low plasma glucose (PG) levels and decreases bone resorption, and GIP(1-30)NH2. In vitro and rodent studies has shown similar physiological effects of GIP(1-30)NH2 and GIP(1-42), but effects in humans remain unexplored. Here, we infused GIP(1-42) and GIP(1-30)NH2 in humans to establish the physiological effects of GIP(1-30)NH2. On three separate days, 10 healthy men (mean age 23 (range 20-28) years, BMI 22.4 (20.0-25.2) kg/m2) received intravenous infusions of GIP(1-42), GIP(1-30)NH2 and saline, respectively. Both peptides were infused at 4 pmol/kg/min during 200 minutes. After 20 minutes of infusion, PG was clamped at the fasting PG level (FPG) for 60 minutes, followed by 60 minutes at FPG × 1.5, and lastly 60 minutes at FPG × 2. There were no differences in PG levels between the three interventions, but significantly more glucose was needed for the clamp with GIP(1-42) compared to saline (P = 0.022). Plasma levels of GIP(1-30)NH2 reached a mean (± SD) of 31.4 ± 29.9 pmol/l and GIP(1-42) of 97.8 ± 27.9 pmol/l. Despite this difference, both infusions resulted in robust and glucose-dependent insulin responses (as assessed by serum C-peptide) with no differences between the two peptide infusions (P = 0.187), and at FPG level only GIP(1-30)NH2 resulted in higher glucagon levels than saline (P = 0.0302). At 180 minutes, the bone resorption marker carboxy-terminal collagen I crosslinks (CTX) was suppressed to 61 ± 13% of baseline values during saline, 42 ± 16% during GIP(1-30)NH2, and 29 ± 6% during GIP(1-42) (P &amp;lt; 0.001). We conclude that, like GIP(1-42), GIP(1-30)NH2 is a potent insulinotropic (at high PG levels), glucagonotropic (at low PG levels) and bone resorption-inhibiting hormone in healthy subjects. Disclosure L.S.L. Krogh: None. L.S. Gasbjerg: Stock/Shareholder; Self; Antag Therapeutics. S. Stensen: None. K. Skov-Jeppesen: None. M.M. Rosenkilde: Consultant; Self; Antag Therapeutics. B. Hartmann: None. T. Vilsbøll: None. J.J. Holst: Advisory Panel; Self; Novo Nordisk A/S. F.K. Knop: Advisory Panel; Self; AstraZeneca, MedImmune, Merck Sharp &amp; Dohme Corp., Mundipharma, Novo Nordisk A/S, Sanofi. Consultant; Self; Amgen Inc., Carmot Therapeutics, Novo Nordisk A/S. Research Support; Self; AstraZeneca, Novo Nordisk A/S. Speaker's Bureau; Self; AstraZeneca, MedImmune, Merck Sharp &amp; Dohme Corp., Mundipharma, Norgine, Novo Nordisk A/S.

Post–Kidney-Transplant Diabetes: Evaluation of Risk Factors

IntroductionPost-transplant diabetes mellitus is a complication of kidney transplantation with deleterious effects on graft and patient survival and is associated with higher mortality. The goal of this paper is to identify risk factors that contribute to its development so that it can be avoided. MethodsWe performed a retrospective analysis of 659 kidney transplants performed in adult patients between January 2013 and December 2017. We excluded patients with a previous diagnosis of diabetes mellitus and identified 61 patients with post-transplant diabetes mellitus (10.6%), then compared them to a control group of 61 patients who did not suffer from the disease, namely the kidney transplant pair or the patient submitted for transplant immediately after. DiscussionA comparative analysis of the 2 groups revealed significant differences regarding the use of β-blockers, fasting glucose on the fifth day post-transplant, kidney recipient age, and body mass index. Using multivariate logistic regression methods, 2 variables with an impact on post-transplant diabetes development were found: fasting glucose on the fifth day post-transplant (odds ratio 1.044, 95% confidence interval 1.010–1.079, P = .010) and body mass index (odds ratio 1.130, 95% confidence interval 1.009–1.264, P = .034). We did not find any differences for other potential risk factors. ConclusionA high plasma glucose level on the fifth day after the transplant and a high body mass index in the setting of the transplant can potentially impact the transplant's outcomes, so it is important to identify these levels as soon as possible to take measures to prevent this disease.

Short and long-term prognostic value of admission glycosylated hemoglobin and plasma glucose in nondiabetic patients with acute myocardial infarction

In nondiabetic patients with acute myocardial infarction (AMI), acute hyperglycemia is associated with high-risk of cardiovascular (CV) mortality but the prognostic value of glycosylated haemoglobin (HbA 1c ) remains uncertain. In a large observational study, we aimed to identify the prognostic values of admission HbA1c and plasma glucose for acute MI in non-diabetic patients regarding in-hospital and one-year CV mortality. From the RICO survey database all the consecutive non-diabetic patients with AMI ( N = 6884) from January 2001 to June 2016 were included. Cut off levels (high/low) were determined by ROC curve analysis for the prediction of CV one-year death (HbA 1c : 5.9% and glucose: 156 mg/dL) to set up 4 groups: low HbA 1c /low glucose ( N = 3849), low HbA 1c /high glucose ( N = 734), high HbA 1c /low glucose ( N = 1802) and high HbA 1c /high glucose ( N = 499). Elevation of glucose or HbA1c was associated with elevated rate of hospital mortality, when compared to all other groups ( Fig. 1 ). By multivariate logistic regression analysis, only high glucose remains a prognostic factor of hospital death (OR(95%CI): 1.59 (1.16–2.17)). In survivors at discharge, group with elevated levels of both plasma glucose and HbA 1c had a higher rate of one-year CV mortality compared to all other groups ( P < 0.001). High HbA 1c was an independent predictive factor of one-year CV mortality, beyond high glucose (OR(95%CI): 1.75(1.35–2.27) and 1.98(1.49–2.61), respectively) and covariates ( Fig. 1 ). In our large population-based study in nondiabetic patients with AMI, high levels of admission HbA 1c and/or plasma glucose give different prognostic information and were associated with increased risk of mortality at short or long-term. Early mortality risk was mainly driven by acute hyperglycemia and one-year mortality by HbA 1c , independently of plasma glucose. Our findings may help identifying high-risk patients to target for aggressive secondary prevention after AMI.

Association of metabolic syndrome and its components with suicidal ideation and depression in adults: A nationally representative sample of the Korean population

BackgroundFew studies have evaluated the association of depressive symptoms and suicidal ideation with metabolic syndrome (MetS) and its components. This study examined the associations of MetS and its components with suicidal ideation and depression and determined the mediation effect of self-rated health (SRH) on these associations. MethodsThis study was conducted using cross-sectional data on 9867 people (aged ≥ 19 years old) collected in 2014 and 2016 from a nationally representative sample of the Korean National Health and Nutrition Examination Survey. The associations of MetS with suicidal ideation and depression were estimated after adjusting for potential confounding factors using logistic regression analyses, and a mediation analysis by Hayes and Preacher was used to estimate the mediation pathway between such associations through SRH. ResultAfter adjusting for confounding factors, suicidal ideation was associated with MetS. Depressive symptoms and suicidal ideation were associated with two components of MetS: high triglyceride level and high fasting plasma glucose level. In the mediation analysis, we found a significant mediating effect of SRH on the association between high triglyceride level and suicidal ideation. LimitationsWe cannot elucidate causal relationships because of the cross-sectional design. ConclusionOur study provides the implication that a high triglyceride level and elevated fasting plasma glucose level may contribute suicidal risk and depressive symptoms in adults and that SRH may contribute to the development of suicidal ideation in adults via the apparent interaction with one of the components of MetS—high triglyceride level.

Short and long-term prognostic value of admission glycosylated hemoglobin and plasma glucose in nondiabetic patients with acute myocardial infarction

In nondiabetic patients with acute myocardial infarction (AMI), acute hyperglycemia is associated with high risk of cardiovascular (CV) mortality but the prognostic value of glycosylated hemoglobin (HbA1c) remains uncertain. In a large observational study, we aimed to identify the prognostic values of admission HbA1c and plasma glucose for acute MI in nondiabetic patients regarding in-hospital and one-year CV mortality. From the RICO survey database all the consecutive nondiabetic patients with AMI ( n = 6884) from January 2001 to June 2016 were included. Cut off levels (high/low) were determined by ROC curve analysis for the prediction of CV one-year death (HbA1c: 5.9% and glucose: 156 mg/dL) to set up 4 groups: low HbA1c/low glucose ( n = 3849), low HbA1c/high glucose ( n = 734), high HbA1c/low glucose ( n = 1802) and high HbA1c/high glucose ( n = 499). Elevation of glucose or HbA1c was associated with elevated rate of hospital mortality, when compared to all other groups ( Fig. 1 ). By multivariate logistic regression analysis, only high glucose remains a prognostic factor of hospital death [OR(95% CI): 1.59 (1.16–2.17)]. In survivors at discharge, group with elevated levels of both plasma glucose and HbA1c had a higher rate of one-year CV mortality compared to all other groups ( P < 0.001). High HbA1c was an independent predictive factor of one-year CV mortality, beyond high glucose [OR(95% CI): 1.75 (1.35–2.27) and 1.98 (1.49–2.61), respectively] and covariates ( Fig. 1 ). In our large population-based study in nondiabetic patients with AMI, high levels of admission HbA1c and/or plasma glucose give different prognostic information and were associated with increased risk of mortality at short or long term. Early mortality risk was mainly driven by acute hyperglycemia and one-year mortality by HbA1c, independently of plasma glucose. Our findings may help identifying high-risk patients to target for aggressive secondary prevention after AMI.

Patterns of Cardiometabolic Health as Midlife Women Transition to Menopause: A Prospective Multiethnic Study.

Cardiometabolic conditions increase in midlife, but early customized prevention strategies are not established for such women. To characterize and identify factors longitudinally related to constellations of cardiometabolic risk components in multiracial/ethnic women in midlife. We conducted a prospective, longitudinal, multiethnic cohort study of 3003 midlife women undergoing menopausal transition (MT). Metabolic syndrome (MetS) was defined as having at least three of five components: high fasting triglyceride (hTG) level, low high-density lipoprotein cholesterol (lHDL-C) level, high fasting plasma glucose (hGluc) level, large waist circumference (abdominal obesity; Ob), and hypertension (HTN). We described the patterns of constellations and estimated hazard ratios (HRs) for constellations at (i) incident MetS and (ii) recovery from MetS, using multivariable-adjusted Cox regression. Seven US sites. In all, 1412 non-Hispanic white, 851 black, 272 Japanese, 237 Hispanic, and 231 Chinese women. Race/ethnicity, lifestyle factors, and MT stage. Cardiometabolic constellations, incident MetS, and MetS recovery. Central obesity was the most frequent component. Having no components was the most frequent (31%) baseline constellation. Physical activity (HR = 1.68; 95% CI: 1.06, 2.68) and lower caloric intake (HR = 0.96; 95% CI: 0.93, 0.99 per 100 cal/d) were associated with recovery from MetS. Ob/hTG/lHDL-C (18%), Ob/HTN/lHDL-C (16%), and Ob/HTN/hGluc (14%) were frequent incident constellations. Physically active women had 26% to 62% lower hazards of incident MetS than inactive women. Modifiable lifestyle behaviors were related to recovery from MetS and decreased risk of the most frequent MetS constellations in midlife women.

Maternal dietary pattern characterised by high protein and low carbohydrate intake in pregnancy is associated with a higher risk of gestational diabetes mellitus in Chinese women: a prospective cohort study.

Maternal dietary patterns and macronutrients intake have been shown to affect the development of gestational diabetes mellitus (GDM), but the findings are inconsistent. We aimed to identify maternal dietary patterns and examine their associations with GDM risk, and to evaluate the contributions of macronutrients intake to these associations. We included 2755 Chinese pregnant women from the Tongji Maternal and Child Health Cohort. Dietary intakes were assessed using a validated semi-quantitative FFQ 2 weeks before the diagnosis of GDM. GDM (n 248) was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24-28 weeks gestation. We derived five different dietary patterns from a principal component analysis. The results showed that high fish-meat-eggs scores, which were positively related to protein intake and inversely related to carbohydrate intake, were associated with a higher risk of GDM (adjusted OR for quartile 4 v. quartile 1: 1·83; 95 % CI 1·21, 2·79; P trend=0·007) and higher plasma glucose levels. In contrast, high rice-wheat-fruits scores, which were positively related to carbohydrate intake and inversely related to protein intake, were associated with lower risk of GDM (adjusted OR for quartile 3 v. quartile 1: 0·54; 95 % CI 0·36, 0·83; P trend=0·010) and lower plasma glucose levels. In addition, dietary protein and carbohydrate intake significantly contributed to the associations between dietary patterns and GDM risk or glucose levels. These findings suggest that a dietary pattern characterised by high protein and low carbohydrate intake in pregnancy was associated with a higher risk of GDM, which may provide important clues for dietary guidance during pregnancy to prevent GDM.

Impact of Glycated Haemoglobin on salivary glucose among type 1 diabetic mellitus patients aged 18-22 years

Background: Diabetes mellitus consists of a group of diseases characterized by abnormally high blood glucose levels. Glycated haemoglobin (HbA1c) is a form of haemoglobin used to identify the average concentration of plasma glucose over prolonged periods of time. It is formed in a non-enzymatic pathway by normal exposure of hemoglobin to high levels of plasma glucose, The main alterations observed in the saliva of Type 1 diabetic patients are hyposalivation and alteration in its composition, particularly those related to the levels of glucose. The aim of the present study was to assess the effect of Glycated haemoglobin level on the level of salivary glucose which may have an effect on oral health condition. Materials and methods: The total sample composed of 50 adults aged 18-22 years. Divided into two groups: 25 uncontrolled diabetes mellitus (HbA1c &gt; 7), 25 controlled diabetes mellitus (HbA1c ≤ 7). Stimulated salivary samples were collected under standardized condition according to the criteria of Tenovuo and Lagerlöf (1994). Salivary glucose was estimated by using spectrophotometric analysis. The data were analyzed by using SPSS version 18 (Statistical Package for Social Sciences) to specify the statistical differences between the two groups. Results: the data of the present study assessed the correlation coefficients of HbA1c and salivary glucose and found that among uncontrolled diabetic group the relation between HbA1c and salivary glucose was significantly in positive direction (r = 0.483 p

Impact of Glycated Haemoglobin on salivary glucose among type 1 diabetic mellitus patients aged 18-22 years

Background: Diabetes mellitus consists of a group of diseases characterized by abnormally high blood glucose levels. Glycated haemoglobin (HbA1c) is a form of haemoglobin used to identify the average concentration of plasma glucose over prolonged periods of time. It is formed in a non-enzymatic pathway by normal exposure of hemoglobin to high levels of plasma glucose, The main alterations observed in the saliva of Type 1 diabetic patients are hyposalivation and alteration in its composition, particularly those related to the levels of glucose. The aim of the present study was to assess the effect of Glycated haemoglobin level on the level of salivary glucose which may have an effect on oral health condition. Materials and methods: The total sample composed of 50 adults aged 18-22 years. Divided into two groups: 25 uncontrolled diabetes mellitus (HbA1c > 7), 25 controlled diabetes mellitus (HbA1c ≤ 7). Stimulated salivary samples were collected under standardized condition according to the criteria of Tenovuo and LagerlA¶f (1994). Salivary glucose was estimated by using spectrophotometric analysis. The data were analyzed by using SPSS version 18 (Statistical Package for Social Sciences) to specify the statistical differences between the two groups. Results: the data of the present study assessed the correlation coefficients of HbA1c and salivary glucose and found that among uncontrolled diabetic group the relation between HbA1c and salivary glucose was significantly in positive direction (r = 0.483 p

Sex differences in outcomes and associated factors among stroke patients with small artery occlusion in China

BackgroundSex differences in outcomes after small artery occlusion (SAO) stroke have not been well described, particularly in a Chinese population. We aimed to assess sex differences in outcomes and related risk factors among patients with SAO.MethodsAll consecutive patients with SAO were recruited between May 2005 and September 2014. Clinical features and risk factors were recorded. The mortality, recurrence, and dependency rates at 3 months after stroke were assessed.ResultsA total of 2524 patients with SAO were included in this study. There was a higher frequency of mild stroke, current smoking, and alcohol consumption in men than in women. Women were more likely than men to be older, to have diabetes and obesity, and to have higher total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. There were worse outcomes in men than in women at 3 months after stroke (P < 0.05). There were more independent risk factors of poor outcome in men than in women. Older age was a common predictive factor of outcome both in men and in women. In men, low triglyceride levels and high fasting plasma glucose levels were independent risk factors for mortality; in addition, a high low-density lipoprotein cholesterol level was associated with recurrence. Moreover, in men, moderate and severe stroke, and high total cholesterol and fasting plasma glucose levels were risk factors for dependency. A negative association was found between low-density lipoprotein cholesterol level and risk of mortality and between total cholesterol level and risk of recurrence in women.ConclusionsThese findings suggest that it is crucial to control conventional risk factors and fasting plasma glucose and lipid levels among patients with SAO, especially male patients, to reduce the burden of stroke in China.

The PCSK9/LDLR axis impacts insulin secretion and glucose response

Aim: PCSK9 genetic variants are associated with lower LDL-Cholesterol levels but also with higher plasma glucose levels and increased risk of T2D. We investigated the molecular mechanisms beyond this association.

PCSK9 deficiency reduces insulin secretion and promotes glucose intolerance: the role of the low-density lipoprotein receptor.

PCSK9 loss of function genetic variants are associated with lower low-density lipoprotein cholesterol but also with higher plasma glucose levels and increased risk of Type 2 diabetes mellitus. Here, we investigated the molecular mechanisms underlying this association. Pcsk9 KO, WT, Pcsk9/Ldlr double KO (DKO), Ldlr KO, albumin AlbCre+/Pcsk9LoxP/LoxP (liver-selective Pcsk9 knock-out mice), and AlbCre-/Pcsk9LoxP/LoxP mice were used. GTT, ITT, insulin and C-peptide plasma levels, pancreas morphology, and cholesterol accumulation in pancreatic islets were studied in the different animal models. Glucose clearance was significantly impaired in Pcsk9 KO mice fed with a standard or a high-fat diet for 20 weeks compared with WT animals; insulin sensitivity, however, was not affected. A detailed analysis of pancreas morphology of Pcsk9 KO mice vs. controls revealed larger islets with increased accumulation of cholesteryl esters, paralleled by increased insulin intracellular levels and decreased plasma insulin, and C-peptide levels. This phenotype was completely reverted in Pcsk9/Ldlr DKO mice implying the low-density lipoprotein receptor (LDLR) as the proprotein convertase subtilisin/kexin Type 9 (PCSK9) target responsible for the phenotype observed. Further studies in albumin AlbCre+/Pcsk9LoxP/LoxP mice, which lack detectable circulating PCSK9, also showed a complete recovery of the phenotype, thus indicating that circulating, liver-derived PCSK9, the principal target of monoclonal antibodies, does not impact beta-cell function and insulin secretion. PCSK9 critically controls LDLR expression in pancreas perhaps contributing to the maintenance of a proper physiological balance to limit cholesterol overload in beta cells. This effect is independent of circulating PCSK9 and is probably related to locally produced PCSK9.