High Prevalence Of Glucose Intolerance Research Articles

Correlation between fetal subcutaneous fat thickness and insulin resistance through cord blood analysis immediately after delivery

ObjectivesThis study aimed to determine whether fetal subcutaneous tissue (SCT) thickness, measured using ultrasound immediately before and after delivery, can reflect changes in glucose metabolism immediately after delivery. We also evaluated the impact of insulin resistance changes during pregnancy by comparing pregnant women with well-controlled gestational diabetes mellitus (GDM) and those with normal glucose metabolism. Study designThe study participants were 117 pregnant women, including 97 controls and 20 patients with GDM who visited our obstetric clinic between February and December 2022. The participants were scheduled for cesarean delivery at a gestational age of ≥37 weeks. SCT thickness before delivery was measured using ultrasound and within 48 h after delivery using Holtain calipers. The glucose and insulin concentrations were quantified from cord blood collected immediately after delivery. Based on these results, a Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was performed to assess insulin resistance. Independent t-test or Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables were used to compare the various parameters. Correlations among the variables in each group were assessed by calculating the correlation coefficient (Pearson’s correlation). ResultsSCT thickness measured using ultrasound and calipers demonstrated a strong correlation where pregnant women with GDM exhibited thicker fetal SCT and neonate skinfolds than in those without GDM. Glucose and insulin levels in the cord blood were significantly elevated (p < 0.05) in the gestational diabetic group, along with remarkable differences (p < 0.001) in HOMA-IR. These variables indicated a higher prevalence of glucose intolerance in the neonates of mothers with GDM. In pregnant women with GDM, there was a statistically significant correlation between fetal abdominal SCT thickness and glucose levels (r = 0.64, p < 0.01) and HOMA-IR (r = 0.48, p < 0.05). ConclusionsMeasuring the subcutaneous fat thickness of the fetus shortly before delivery is beneficial for predicting insulin resistance in neonates. This is considered particularly useful for women with effectively managed GDM, where the presence of conditions such as macrosomia may not be pronounced.

Impact of Risk Factors on Short and Long-Term Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus: A Prospective Longitudinal Cohort Study.

AimsUniversal screening of gestational diabetes mellitus (GDM) in women with no risk factors (RF) for GDM remains controversial. This study identified the impact of the presence of RF on perinatal and postpartum outcomes.MethodsThis prospective cohort study included 780 women with GDM. GDM RF included previous GDM, first grade family history of type 2 diabetes, high-risk ethnicity and pre-pregnancy overweight/obesity (OW/OB). Outcomes included obstetrical, neonatal and maternal metabolic parameters during pregnancy and up to 1 year postpartum.ResultsOut of 780 patients, 24% had no RF for GDM. Despite this, 40% of them needed medical treatment and they had a high prevalence of glucose intolerance of 21 and 27% at 6-8 weeks and 1-year postpartum, respectively. Despite similar treatment, women with RF had more neonatal and obstetrical complications, but they had especially more frequent adverse metabolic outcomes in the short- and long-term. The most important RF for poor perinatal outcome were previous GDM and pre-pregnancy OW/OB, whereas high-risk ethnicity and pre-pregnancy OW/OB were RF for adverse postpartum metabolic outcomes. Increasing number of RF were associated with worsened perinatal and long-term postpartum outcomes except for pregnancy-induced hypertension, C-section delivery and neonatal hypoglycaemia.ConclusionWomen with no RF had a high prevalence of adverse perinatal and postpartum outcomes, while the presence of RF particularly increased the risk for postpartum adverse metabolic outcomes. This calls for a RF-based long-term follow-up of women with GDM.

Risk Factors and Management of Kidney Diseases in Saudi Women with Diabetes

Background:The prevalence of diabetic kidney diseases (DKD) in the Saudi population is increasing and its prevalence has been reported as 37.4%. Recently, a higher prevalence of albuminuria in women has been proven through population-based studies.Objectives:Recently, the Kingdom of Saudi Arabia (KSA) has witnessed many changes in women’s activities, and women are more actively participating in the social and cultural development of the country. Thus, focusing on women’s health-related issues has become crucial. The necessity of research focusing on the influence of various risk factors on DKD has emerged as a priority.Methods:The literature search was done by search engines and databases (PubMed, Google scholar and EMBASE). From a total of 21 selected articles, 18 articles are included in this study.Results:This review emphasizes on the higher influence of certain DKD risk factors on Saudi women including a high prevalence of glucose intolerance during pregnancy, obesity due to lack of physical activity, and genetic predisposition due to consanguineous marriages, etc.Conclusion:This study can raise awareness regarding the prevention and management of DKD in Saudi diabetic women.

Sex Hormones and Development of Advanced Diabetic Nephropathy in Diabetic Kidney Disease

Diabetic kidney disease (DKD) is a common complication of diabetes, which frequently leads to end‐stage renal failure and increases the risk of cardiovascular disease. Hyperglycemia promotes the development of renal pathologies such as glomerulosclerosis, tubular hypertrophy, microalbuminuria, and a decline in glomerular filtration rate. Importantly, recent clinical data have demonstrated distinct sexual dimorphism in the pathogenesis of DKD in people with diabetes, which impacts both severity‐ and age‐related risk factors. Recently, we described the development of advanced forms of diabetic nephropathy (DN) and glomerular damage in the type 2 diabetic nephropathy (T2DN) rat model. Since the progression of renal disease in T2DN rats closely parallels that of human DKD, we questioned whether this strain also displays sexual dimorphisms comparable to the human population. Male and female T2DN rats at &gt;48 weeks of age were used to evaluate hyperglycemia, renal injury, and renal function during the advanced stage of DN. We found that there were significant differences in fasting blood glucose levels for males versus females (156 ± 8 vs. 124 ± 4 mg/dL, respectively). Glucose tolerance tests revealed a higher prevalence of glucose intolerance in males (378 ± 19 vs. 183 ± 48 mg/dL for male vs. female). The development of albuminuria and glomerular damage was significantly different between sexes (11.8 ± 5.7 vs. 0.98 ± 0.64 Alb/Cre ratio, and 28 vs. 4 % with the highest damage score, male vs. female). These changes, accompanied by a significant increase in urinary nephrin shedding in males, suggested pathological changes to the glomerular filtration barrier. Detailed analyses of plasma samples also indicated striking differences in cholesterol (261.2 ± 46.7 vs. 86.7 ± 2.7 mg/dL), blood urea nitrogen (22.2 ± 2 vs. 17.1 ± 0.8 mg/dL), albumin homeostasis and alkaline phosphatase (ALP) levels in males compared to females. Echocardiography analyses of the cardiac output, left ventricle wall thickness, fractional shortening, and heart rate did not differ between strains, suggesting that the DN‐related effects on renal and metabolic phenotypes in the T2DN rats do not induce additional cardiac pathology. Additionally, microbiome analyses indicate that the contribution of microbiota to the observed gender differences in T2DN phenotypes is minimal. To test the role of the endocrine environment in physiology and pathophysiology of type 2 diabetes, we performed gonadectomy on male and female T2DN rats at 9 to 10 weeks old. We found that at 32 weeks of age, gonadectomized male T2DN rats have a significant reduction in fasting blood glucose versus their intact controls; however, female rats have no significant changes between groups (128 ± 9 vs. 170 ± 14, and 94 ± 4 vs. 105 ± 4 mg/dL for gonadectomized vs. control male and female rats, respectively). In conclusion, sex differences in the T2DN renal phenotype are ultimately the result of multiple changes and potentially depend on male hormonal signaling, which likely stimulates the progression of diabetes and the development of renal damage.Support or Funding InformationNIH HL135749, AHA 18PRE34030127 , VA I01 BX004024

Association of Androgen Excess with Glucose Intolerance in Women with Polycystic Ovary Syndrome

Women with polycystic ovary syndrome (PCOS) show high prevalence of glucose intolerance. This study aimed to investigate the association of androgen excess with glucose intolerance in PCOS. A total of 378 women with PCOS participated in the study. Free androgen index (FAI) was selected as indicator of hyperandrogenism. Insulin sensitivity was assessed by 1/homeostasis model assessment of insulin resistance (1/HOMA-IR) and Matsuda insulin sensitivity index (ISIM); β-cell function was assessed by disposition index (DI). We found that women with glucose intolerance had higher FAI levels compared to women with normal glucose tolerance (NGT) (prediabetes 6.2, T2DM 7.9 versus NGT 5.0, resp.; p < 0.001). Furthermore, there was a direct association between FAI levels and frequency of glucose intolerance (OR = 2.480, 95% CI 1.387–4.434), even after adjusting for age, BMI, waist circumference, hypertension, fasting insulin, testosterone, SHBG, and family history of diabetes. In addition, with FAI increase, glycosylated hemoglobin (HbA1c), plasma glucose concentrations, and serum insulin levels increased, while insulin sensitivity and β-cell function decreased. Our results suggested that androgen excess indicated by high FAI levels might serve as indicator of glucose intolerance, as it might promote insulin resistance and β-cell dysfunction in women with PCOS.

Postpartum glucose testing, related factors and progression to abnormal glucose tolerance in a rural population with a known history of gestational diabetes

Aims: Gestational diabetes is a strong risk factor for postpartum progression to glucose intolerance. The aims of the study were to determine rate of postpartum glucose testing , its related factors and rate of progression to glucose intolerance in women who underwent postpartum glucose testing after pregnancy that complicated by gestational diabetes.Materials: this is a retrospective study and women with gestational diabetes who received prenatal care during 2005-2015 in 3 rural health centers of Khuramshahr (southwestern of Iran) were enrolled. Gestational diabetes mellitus diagnosed by FPG test only, 75g OGTT or GCT. The American Diabetes Association(ADA) criteria applied for definition of postpartum glucose intolerance (pre-diabetes or diabetes) .Results: Mean duration of follow-up was 29.7 months. BMI≥ 25 was detected in 73.3% and 78.7% of women during pre-pregnancy and postpartum respectively. Overall 45.8% (60/131) of women received postpartum glucose testing. Rate of progression to abnormal glucose tolerance was 23.3% (8.5% pre-diabetes and 15.2% diabetes). Advanced maternal age was associated with postpartum glucose testing (OR 1.066, CI 1.008-1.128, p=0.02).Discussion: high rate of overweight and obesity, sub optimal rate of postpartum glucose testing and high prevalence of glucose intolerance, highlights the importance of postpartum screening with a more sensitive test and implementation of an intervention program to prevent type 2 diabetes in rural population particularly older women with prior gestational diabetes.

Variation of glucose tolerance in adult patients with cystic fibrosis: What is the potential contribution of insulin sensitivity?

BackgroundReduced insulin secretion is a key factor to explain high prevalence of glucose intolerance in patients with cystic fibrosis (CF). However, the role of insulin sensitivity remains unclear. The aim of this study is to investigate the association of insulin secretion and sensitivity with the evolution of glucose tolerance. MethodsA total of 152 patients without known diabetes from the Montreal CF cohort underwent two 2-h oral glucose tolerance tests (OGTT) at baseline and again after 21.2±5.5months. Pulmonary function and anthropometric measurements were also collected at each visit. At both visits, based on their OGTT results, patients were categorized in glucose tolerance groups (normal glucose tolerance, impaired glucose tolerance or CF-related diabetes) and stratified in 3 groups according to the variation of their glucose tolerance: stable, improved or deteriorated. ResultsAt baseline, patients in the deteriorated group had a better sensitivity to insulin than those in the improved group (P=0.029). At follow-up glucose tolerance remained stable in 55.3%, improved in 14.5% and deteriorated in 30.3% of patients. During follow-up, insulin secretion remained stable in all 3 groups. While insulin sensitivity remained stable in patients without changes in glucose tolerance it worsened in patients who deteriorated glucose tolerance (P<0.001) and improved in patients who improved their glucose tolerance (P=0.003). ConclusionIn a context of significantly reduced insulin secretion, variations of insulin sensitivity are associated with variations of glucose tolerance in adult patients with CF.

Glucose intolerance associated with hypoxia in people living at high altitudes in the Tibetan highland

ObjectivesTo clarify the association between glucose intolerance and high altitudes (2900–4800 m) in a hypoxic environment in Tibetan highlanders and to verify the hypothesis that high altitude dwelling increases vulnerability...

Patients with normocalcemic primary hyperparathyroidism may have similar metabolic profile as hypercalcemic patients

Primary hyperparathyroidism is well known to be associated with cardiovascular morbidity and mortality. However, it is unclear whether normocalcemic primary hyperparathyroidism (NC-PHPT) and hypercalcemic primary hyperparathyroidism (HC-PHPT) share the same risk factors. We aimed to determine prevalence of metabolic syndrome in NC-PHPT and compare metabolic syndrome parameters and insulin resistance in NC-PHPT subjects with those in HC-PHPT and control subjects. After excluding patients with secondary hyperparathyroidism, the study enrolled 25 patients with NC-PHPT, 24 patients with HC-PHPT and 30 age-gender matched controls. All participants were evaluated using the International Diabetes Federation (IDF)-2006 metabolic syndrome criteria. Compared with HC-PHPT patients, NC-PHPT patients had similar prevalence of metabolic syndrome, glucose intolerance, and previous history of hypertension/anti-hypertensive medications, but compared with controls, NC-PHPT patients had significantly higher prevalence of glucose intolerance and previous history of hypertension/anti-hypertensive medications. Not serum calcium but PTH concentration was found to be significantly higher in those with glucose intolerance. Serum fasting triglyceride concentration and waist circumference were found to be positively correlated only with serum PTH concentration. In conclusion, patients with NC-PHPT may be prone to similar metabolic disturbances linked to higher cardiovascular risk like patients with HC-PHPT. Although NC-PHPT is thought to occur early in the development of the classical disease, it should be monitored regularly because of its metabolic consequences.

Resveratrol Decreases TXNIP mRNA and Protein Nuclear Expressions With an Arterial Function Improvement in Old Mice.

Aging leads to a high prevalence of glucose intolerance and cardiovascular diseases, with oxidative stress playing a potential role. Resveratrol has shown promising effects on glucose tolerance and tends to improve endothelial function in elderly patients. Thioredoxin-interacting protein (TXNIP) was recently proposed as a potential link connecting glucose metabolism to oxidative stress. Here, we investigated the resveratrol-induced improvement of arterial aging phenotype in old mice and the expression of aortic TXNIP. Using an in vivo model of old mice with or without 3-month resveratrol treatment, we investigated the effects of resveratrol on age-related impairments from a cardiovascular Doppler analysis, to a molecular level, by studying inflammation and oxidative stress factors. We found a dual effect of resveratrol, with a decrease of age-related glucose intolerance and oxidative stress imbalance leading to reduced matrix remodeling that forestalls arterial aging phenotype in terms of intima-media thickness and arterial distensibility. These results provide the first evidence that aortic TXNIP mRNA and protein nuclear expressions are increased in the arterial aging and decreased by resveratrol treatment. In conclusion, we demonstrated that resveratrol helped to restore several aging impaired processes in old mice, with a decrease of aortic TXNIP mRNA and protein nuclear expressions.

Concurrent Type 2 Diabetes and Multiple Endocrine Neoplasia Type 1 With a Novel MEN1 Gene Mutation

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited disorder that is characterized by the combined occurrence of primary hyperparathyroidism (PHPT), enteropancreatic neuroendocrine tumors and anterior pituitary adenomas. Increased insulin resistance and a higher prevalence of glucose intolerance have been noted in MEN1 families and are associated with increased cardiovascular mortality. Mutations in the MEN1 tumor suppressor gene cause multiple tumors in MEN1 but can also be associated with glycemic dysregulation. A 52-year-old man was admitted for blood glucose control. He had been diagnosed with diabetes 3 years previously. Hypercalcemia was incidentally detected during a blood test. After examination, he was diagnosed with PHPT caused by parathyroid hyperplasia. On genetic analysis, he was found to have a novel mutation in the MEN1 gene (exon 10, c.1590_1606_del; p.Gly532AlafsX20). We report a case of MEN1 with a novel MEN1 gene mutation associated with type 2 diabetes in a patient with no family history of diabetes. This is the first case of MEN1 associated with type 2 diabetes before pancreatic surgery in Korea. J Med Cases. 2014;5(11):596-600 doi: http://dx.doi.org/10.14740/jmc1973w

Prevalence and predictors of postpartum glucose intolerance in Italian women with gestational diabetes mellitus

AimsTo determine the prevalence of both prediabetes and type 2 diabetes mellitus (T2DM) by postpartum oral glucose tolerance test (ppOGTT) in Italian women diagnosed with gestational diabetes mellitus (GDM), and identify antepartum predictors of glucose intolerance. MethodsRetrospective study of 454 Caucasian women that underwent a 75g OGTT between 6 and 12 weeks postpartum in Calabria (Southern Italy) between 2004 and 2012. Prediabetes and T2DM were diagnosed according to the American Diabetes Association (ADA) criteria. Data were examined by univariate analysis and multiple regression analysis. Results290 women (63.9%) were normal, 146 (32.1%) had prediabetes (85 impaired fasting glycemia; 61 impaired glucose tolerance), and 18 (4.0%) had T2DM. Of the continuous variables, pre-pregnancy body mass index (BMI), age at pregnancy, fasting plasma glucose (FPG) at gravid OGTT, and week at diagnosis of GDM were associated with prediabetes and T2DM, whereas the parity was associated with T2DM only. For categorical traits, pre-pregnancy BMI ≥25 and previous diagnosis of polycystic ovary syndrome (PCOS) emerged as the strongest predictors of prediabetes whereas the strongest predictors of T2DM were FPG ≥100mg/dl (5.6mmol/l) at GDM diagnosis and pre-pregnancy BMI ≥25. Moreover, FPG at GDM screening was a good predictor of T2DM after receiver-operating-characteristic analysis. ConclusionsOur findings confirm the high prevalence of glucose intolerance in the early postpartum period in women with previous GDM. PCOS emerges as a new strong antepartum predictor of prediabetes.

Prevalence of pre-diabetes and unreported diabetes mellitus in population aged 45 years and above in Owerri Municipality, Imo State Nigeria

Background: Unreported diabetes mellitus and glucose intolerance have substantial clinical importance. Glucose intolerance precedes diabetes mellitus and it is associated with cardiovascular complications. Subjects with prediabetes have near normal glycated haemoglobin and may only be detected when oral glucose tolerance was performed. Early detection may prevent or delay diabetes and its complications. This study determined the prevalence of un-reported diabetes mellitus and glucose intolerance in Owerri Municipality, Imo State of Nigeria.Methodology: 1,012 apparently healthy subjects aged 45 years and above were recruited for the study. Their anthropometric parameters were measured using standard methods and plasma glucose was measured using glucose oxidase method. Diagnosis of diabetes and pre-diabetes was made according to WHO criteria.Results: A total of 157 subjects had pre-diabetes giving a prevalence of15.5%. Subjects of aged 40 – 59 years were mostly affected. IFG alone, IGT alone and a combination of IFG +IGT occurred in 30.6%, 62.4% and 7.0% respectively of the study population. The highest prevalence of IFG was recorded in the 40 – 49 years age group while that of IGT occurred in the 50 – 59 years range. A combination of IFG and IGT occurred rarely in the study population, 7.0% and none was detected after the age of 59 years. A greater proportion of males, 18%, than females, 14.5%, had pre-diabetes. Unreported diabetes was detected in 8.6% of the study population, most of them in the 50 – 69 years age bracket. It was more prevalent in the female subjects, 11.1% than in the male subjects 4.4%. The mean BMI, WHR, FPG and 2hppG of the pre-diabetes subjects were 28.76 ±3.5kg/m2, 0.94 ±0.14, 5.28 ± 0.75 mmol/l and 8.43 ± 1.57mmol/l respectively. Among the male pre-diabetes subjects, peak values for BMI and FPG occurred after 70 years of age while in their female counterparts, peak mean values for these parameters occurred much earlier, 40 -59 years range.Conclusions: The report showed high prevalence of glucose intolerance and un-reported diabetes mellitus in the population. The need for regular screening of the population for glucose intolerance was highlighted in order to reduce the incidence of diabetes and its complications.Key words: Un-reported diabetes mellitus, impaired fasting glycaemia, impaired glucose tolerance, pre-diabetes.

High Prevalence of Glucose Intolerance and Diabetes in Patients with Coronary Artery Disease

PP-333 Our purpose was to investigate the relationship between the prevalence of glucose intolerance and type 2 diabetes with cardiometabolic risk factors in patients with asymptomatic coronary artery disease. 132 patients who had not been previously diagnosed with glucose intolerance or diabetes

Comparison of Association of Diabetes Mellitus in Hepatitis C Virus Infection and Hepatitis B Virus Infection

Abstract Background: While patients with liver disease are known to have a higher prevalence of glucose intolera-nce, preliminary studies suggest that hepatitis C virus (HCV) infection may be an additional risk factor for the development of diabetes mellitus (DM). Objective: The presented study was aimed to study and determine a relationship between the relative pro-portions of Diabetes Mellitus in patients suffering from HCV infection. Study Design: This cross sectional study. Study Settings: Patients were registered from outdoor as well as indoor departments of different teaching hospitals (Services hospital Lahore and medical depar- tments in Jinnah hospital, Mayo hospital, Sir Ganga Ram hospital) in Lahore, Pakistan. Methods: This cross sectional study was comprised of age and sex matched 258 patients of viral hepatitis B infection and viral hepatitis C infection, conducted at Hepatitis Clinic Services Hospital, affiliated with Post Graduate Medical Institute, Lahore. Diagnosis of HBV was made with evidence of hepatitis B surface antigen, HCV infection was diagnosed if patient was sero positive for anti HCV (ELISA methods) and HCV - RNA (By PCR). Diabetes Mellitus was diag-nosed after fulfilling the American Diabetic Associ-ation Criteria, from November, 2000 to September, 2002. Results: A total of 318 patients were registered, out of which 258 cases fulfilled the inclusion criteria, 164 hepatitis C infected and 94 hepatitis B infected cases, 16.46% hepatitis C infected cases were diagnosed as diabetics while 4.25% hepatitis B infected cases were diagnosed as diabetics. Conclusion: This study concludes that there is high Association and relationship of Diabetes Mellitus with Hepatitis C virus infection as compared with Hepatitis B virus infection. Key words: Hepatitis B, Hepatitis C, diabetes Melli-tus.

The prevalence of glucose metabolism abnormalities in Greek women with polycystic ovary syndrome

The prevalence of glucose metabolism abnormalities in PCOS women worldwide varies between 10 and 40% but there are no data in Greek PCOS women. In this retrospective study the prevalence of glucose abnormalities and the indices of insulin resistance (IR) and whole-body insulin sensitivity were estimated in a Greek population with PCOS. Impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and type 2 diabetes mellitus (t2DM) were calculated. The prevalence of IGT, IFG and t2DM in our PCOS population was 7.6, 5.1 and 1.7%, respectively. The total prevalence of glucose abnormalities was estimated as 14.1%. The prevalence of t2DM was three- to four-fold higher than in the general Greek female population of the same age as this was estimated by 2, recently published studies. PCOS women with increased BMI and waist circumference and age greater than 30 years, present more severe IR and decreased whole-body insulin sensitivity. Our data indicates a relatively high prevalence of glucose intolerance and t2DM in a Greek population with PCOS. Obese women with PCOS are in higher risk to develop glucose abnormalities and probably t2DM later in life and therefore every woman diagnosed with PCOS should undergo a 2-h post load OGTT.

Mechanism and Effects of Glucose Absorption during an Oral Glucose Tolerance Test Among Females and Males

Several epidemiological studies revealed sex-specific differences during oral glucose tolerance tests (OGTTs), such as higher prevalence of glucose intolerance (i.e. increased glucose at the end of the OGTT) in females, which was not yet explained. Thus, we aimed to analyze sex-related distinctions on OGTT glucose metabolism, including gut absorption, in healthy humans. Females (n = 48) and males (n = 26) with comparable age (females, 45 ± 1 yr; males, 44 ± 2 yr) and body mass index (both, 25 ± 1 kg/m(2)) but different height (females, 166 ± 1 cm; males, 180 ± 2 cm; P < 0.000001), all normally glucose tolerant, as tested by frequently sampled, 3-h (75-g) OGTTs, underwent hyperinsulinemic [40 mU/(min · m(2))] isoglycemic clamp tests with simultaneous measurement of endogenous glucose (d-[6,6-(2)H(2)]glucose) production (EGP). EGP and glucose disappearance during OGTT were calculated from logarithmic relationships with clamp test insulin concentrations. After reliable model validation by double-tracer technique (r = 0.732; P < 0.007), we calculated and modeled gut glucose absorption (ABS). Females showed lower (P < 0.05) fasting EGP [1.4 ± 0.1 mg/(kg · min)] than males [1.7 ± 0.1 mg/(kg · min)] but comparable whole-body insulin sensitivity in clamp tests [females, 8.1 ± 0.4 mg/(kg · min); males, 8.3 ± 0.6 mg/(kg · min)]. Plasma glucose OGTT concentrations were higher (P < 0.04) from 30-40 min in males but from 120-180 min in females. Glucose absorption rates were 21-46% increased in the initial 40 min in males but in females by 27-40% in the third hour (P < 0.05). Gut glucose half-life was markedly higher in females (79 ± 2 min) than in males (65 ± 3 min, P < 0.0001) and negatively related to body height (r = -0.481; P < 0.0001). This study in healthy, glucose-tolerant humans shows for the first time different ABS rates during OGTT in women and men and a negative relationship between body height and gut glucose half-life. Prolonged ABS in females might therefore contribute to higher plasma glucose concentrations at the end of OGTT.

Metabolic characteristics of prehypertension: role of classification criteria and gender

We tested whether men and women in the European Society of Hypertension (ESH) high normal and normal blood pressure (BP) categories, all included in the the Seventh Joint National Committee (JNC 7) prehypertension group, share similar metabolic characteristics and whether they differ from men and women with optimal BP (<120/80 mmHg). BP (multiple measurements with a standardized automatic device), insulin sensitivity (euglycaemic clamp), oral glucose tolerance test (OGTT), carotid intima-media-thickness (IMT, echo), family history (questionnaire), physical activity (accelerometer), and anthropometrics (bioimpedance) were evaluated in the 1384 healthy European individuals ranging from 30-60 years participating in the multicentre study Relationship between Insulin Sensitivity and Cardiovascular disease (RISC). BMI and waist-to-hip ratio were higher (both P < 0.05 adjusted for age and recruiting centre) in men and women with high normal (but not normal) BP with respect to optimal BP. Similarly, in women (after adjustment for study centre, age, physical activity, and waist), serum triglycerides and carotid IMT were higher in those with high normal (but not normal) BP; moreover, in this group there was a higher prevalence of glucose-intolerance (21.8 versus 9.7%, P = 0.02) and insulin sensitivity tended to be lower (P = 0.07). Insulin sensitivity and diastolic blood pressure were weakly related variables displaying a nonlinear association with a threshold below the normal BP values and no interaction with family history of hypertension. The JNC 7 category prehypertension identifies a dishomogeneous group of individuals whereas the ESH classification, particularly in women, was more accurate in identifying both the predisease and the healthy phenotype. Insulin resistance is not a major characteristic of the condition of prehypertension.

Prevalence of glucose intolerance in patients with chronic hepatitis B or C: a prospective case–control study

Despite several studies, the association of glucose intolerance with chronic hepatitis B (CHB) or C (CHC) virus infection remains controversial. We evaluated the prevalence of glucose intolerance by oral glucose tolerance test (OGTT) in patients with CHB or CHC in comparison with matched controls. In total, 189 consecutive outpatients with CHB or CHC and 189 subjects individually matched for age, sex and body mass index (BMI) were included. OGTT was performed in all cases, except in known diabetics, and glucose intolerance was defined as impaired glucose tolerance (IGT), OGTT-diabetes or known diabetes. Most patients with abnormal OGTT had normal fasting glucose (IGT: 69.8%, OGTT-diabetes: 54.5%). Compared with their own controls, CHB patients had a higher prevalence of IGT (13.6% vs 2.5%, P = 0.018) and family history of diabetes (34.6% vs 16.0%, P = 0.011), while CHC patents had higher prevalence of glucose intolerance (37.0% vs 15.7%, Rho = 0.001), mostly because of more frequent IGT (21.3% vs 6.5%, Rho = 0.003). After age and BMI adjustment, patients with CHC compared with those with CHB had significantly higher prevalence of glucose intolerance (37.0% vs 29.6%, P = 0.037). In conclusion, increased prevalence of glucose intolerance is documented by OGTT both in CHC and CHB patients compared with age, sex and BMI matched controls. Glucose intolerance is more frequent in CHC than CHB patients, regardless of known risk factors. An OGTT might be necessary at the baseline work-up of CHB or CHC patients, as a normal fasting glucose value does not exclude IGT or OGTT-diabetes.

Effect of Low-Dose Oral Contraceptives on Metabolic Risk Factors in African-American Women

The effect of oral contraceptive pill (OCP) use on cardiovascular risk in African-American women is unknown. Our objective was to examine in African-American women the effect of OCP use on insulin resistance, glucose intolerance, and triglycerides (TGs). This was a cross-sectional study. The study was conducted at the National Institutes of Health Clinical Research Center. A total of 104 healthy nondiabetic African-American women [21 OCP users, 83 controls, age mean +/- sd, 34.7 +/- 7.6 yr, body mass index (BMI) 31 +/- 8.4 kg/m(2)] was included in the study. Subjects had oral glucose tolerance tests, insulin-modified frequently sampled iv glucose tolerance tests, and fasting lipid profiles. Insulin resistance was determined by the insulin sensitivity index (S(I)). Insulin resistance, glucose tolerance status, and TG levels were determined. Fasting glucose did not differ between OCP users and controls (P = 0.27). In contrast, compared with controls, 2-h glucose (135 +/- 23 vs.120 +/- 25 mg/dl; P = 0.01) and fasting TGs (73 +/- 31 vs.57 +/- 27 mg/dl; P = 0.02) were higher in OCP users. OCP users tended to be more insulin resistant than controls (S(I): 2.51 +/- 2.01 vs. 3.46 +/- 2.09; P = 0.09). Multiple regression analysis revealed that BMI, age, and OCP use were significant determinants of 2-h glucose (adjusted R(2) = 0.37; P < 0.001) and TG levels (adjusted R(2) = 0.21; P < 0.001). As BMI was a determinant of both 2-h glucose and TGs, participants were divided into nonobese and obese groups, and the analyses repeated. Among the nonobese women, the OCP users were more insulin resistant (S(I): 2.91 +/- 1.58 vs. 4.35 +/- 1.88; P = 0.03) and had a higher prevalence of glucose intolerance than controls (odds ratio 5.7; 95% confidence interval 1.4-24; P = 0.01). In African-American women, OCP use is associated with an increase in markers of cardiovascular risk manifested by increased insulin resistance, glucose intolerance, and elevated TGs.