IFG Group Research Articles

Association between Serum Ferritin and Insulin Resistance Markers with Distinct Glycemic Profiles in an Adult Bangladeshi Population

Background: Type 2 diabetes mellitus (T2DM) is a global health concern. Around 56% of subjects in Bangladesh go undiagnosed, increasing the risk of stroke and cardiovascular issues. Iron stores' impact on diabetes is gaining attention, with ferritin as a key biomarker. Hyperferritinemia probably contributes to insulin resistance and subsequently to decreased insulin secretion, causing the development of insulin resistance. The link between ferritin and insulin resistance (IR) varies based on ethnicity, gender, and glycemic state. Objectives: This study investigates serum ferritin levels in different glycemic stages and explores potential correlations between ferritin and insulin resistance markers (blood glucose, serum insulin, and HOMA-IR) Methods: The study was conducted at the Department of Biochemistry, Sir Salimullah Medical College, Dhaka, Bangladesh, from March 2018 to February 2019. A total of 140 subjects were included to conduct this study. Participants were categorized into three groups: those with normal fasting glucose (NFG group), impaired fasting glucose (IFG group), and newly diagnosed type 2 diabetes mellitus (Diabetic group) according to WHO (2006) criteria. A purposive convenient sampling method was used, focusing on adults aged 25 to 55 years. Exclusion criteria were applied to eliminate individuals with inflammatory diseases, chronic conditions, major cardiovascular events, anemia, or specific medications that could affect ferritin levels. Results: The study found that serum ferritin levels significantly differed among three glycemic groups (NFG, IFG, and T2DM) with higher levels in T2DM. IFG and T2DM groups also had elevated serum insulin and HOMA-IR. Serum ferritin correlated strongly with fasting blood glucose, serum insulin, HOMA-IR, and BMI. The highest tertile of ferritin levels were associated with the IFG & diabetic group. Conclusion. Elevated serum ferritin levels in IFG and type 2 diabetes may significantly impact glucose regulation. Compared to NFG, there are high insulin resistance markers (fasting insulin, glucose, HOMA-IR) in T2DM and IFG. They have crucial implications for both therapy and prognosis in these conditions. Mugda Med Coll J. 2023; 6(2): 57-63

Serum Carboxylated and Undercarboxylated Osteocalcin association with Coronary Atherosclerosis Disease and Cardiovascular Risk Markers in: Analysis of a Syrian Male Cohort

Background: New assumption concerning association of osteocalcin and Vascular calcification has emerged in reaction to observations that the mechanism of vascular calcification resembles that of bone mineralization, thus linking bone and the vasculature. However, studies reported contrasting results about the association between osteocalcin and atherosclerosis. This study was designed to evaluate capacity relationships among different forms of circulating osteocalcin and cardiovascular risk markers in male with coronary atherosclerosis. Methods: A cross-sectional study was conducted on 58 male patients, divided into two groups according to the severity of coronary artery disease (CAD), as determined by coronary angiography assessment: Early coronary atherosclerosis (ECA), n=20, patients with mild CAD (<50% stenosis in any major epicardial arteries), and late coronary atherosclerosis (LCA), n=38, patients with severe, multivessel CAD (>50% stenosis in at least one or more major epicardial arteries). The healthy control (HC) group included 26 healthy male subjects. Carboxylated (cOC) and ucOC were measured using ELISA technique. Results: We observed significantly lower ucOC levels in both stages of cardiovascular disease (CVD) (ECA and LCA) compared to the HC group (2.34±2.23 and 2.48±1.60 vs 6.65±1.78ng/mL, P<0.01). ucOC was inversely correlated with an increasing number of cardiovascular risk factors (CVRFs). Moreover, ucOC levels were markedly reduced in high-fasting plasma glucose (FPG) groups (IFG and T2DM-threshold level), compared to the normal FPG group (NG). cOC levels were higher in the IFG group, compared to the normal FPG group (8.50±4.76 vs 7.13±3.13ng/mL, p=0.008) possibly predicting such condition. Conclusions: In the present study, patients with coronary atherosclerosis, regardless of the onset of stenosis, showed lower ucOC levels which were inversely correlated with an increasing number of CVRFs. Moreover, ucOC levels were markedly reduced in high-FPG groups. Serum ucOC may be considered as a potential biomarker for coronary atherosclerosis disease and therefore its measurement may help to establish preventive and therapeutic approaches. Moreover, cOC may be associated with a high alert for diabetes at the IFG stage, but not when the disease progresses to diabetes.

Associations between GDF15 levels and pre-diabetes in non-obese subjects

Growth differentiation factor 15 (GDF15) is a stress-response cytokine which belongs to the transforming growth factor β superfamily. Although GDF15 was initially found to have a role in metabolic diseases,...

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels.

[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness.[Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed.[Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups.[Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

The Cross-sectional Effect Of Abnormal Glucose Metabolism On Balance Ability, Muscle Strength, And Body Compositionin Men

PURPOSE: To investigate the association between balance ability, muscle strength, and body composition, and fasting blood glucose METHODS: 1) Subjects: 2693 men (aged 19-73 years old) were recruited from three health management central of hospitals in China, without any diagnosed diseases other than diabetes. 2) Measurements: People’s grip strength was measured 3 times in dominant hand in a standing position and read the highest value; balance ability was measured by one-leg standing time with both eye-closed; body composition was measured by BIA; fasting venous blood was taken for blood glucose test. All subjects were divided into normal blood glucose group (Normal: < 6.1 mmol/L), impaired fasting glucose group (IFG: 6.1-7.0 mmol/L), and diabetes group (DM: ≥7.0 mmol/L). 3) Statistics: Multivariate analysis of variance was used for comparison among groups; Pearson test was used for correction analysis; the significance level (α) for hypothesis testing was set to 0.05. RESULTS: Normal glucose men were significantly younger than those in the IFG and DM group (38.76±9.45 vs. 44.57±9.09 vs. 45.87±4.79 yrs, P < 0.05). Normal glucose men had significantly lower body weight and lower percent body fat than those in the IFG and DM group (BW: 70.70±11.29 vs. 75.68±10.40 vs. 77.23±11.66 kg, P < 0.05; BF%:15.55±6.38 vs. 18.97±5.82 vs. 25.12±5.62, P < 0.05). Balance ability, relative grip strength, and muscle percentage [(body muscle/ body weight)*100) were different in three groups (P < 0.05). There were inverse linear associations between incremental level of blood glucose and lower values of balance ability, relative grip strength, and muscle percentage (r =-0.067 , r =-0.158, r =-0.171 , P < 0.05 for each). After adjusted age, the blood glucose level was still correlated with balance ability (r =-0.035 , P=0.068). CONCLUSIONS:The men’s balance ability decreases with the increase of blood glucose level. There are inverse linear associations between muscle strength and muscle percentage and blood glucose level.Acknowledgement:1) China Health Foundation Project “Multi-Center Application Research on Fitness Fitness Test and Exercise Management” (CHPF2014-FITEX); 2) National Key Research and Development Program Major Prevention and Control Research on Chronic Non-communicable Diseases (2016YFC1300202).

Elevated Hedgehog-Interacting Protein Levels in Subjects with Prediabetes and Type 2 Diabetes.

Background: The prevalence of diabetes is rapidly increasing worldwide and is highly associated with the incidence of cancers. In order to prevent diabetes, early diagnosis of prediabetes is important. However, biomarkers for prediabetes diagnosis are still scarce. The hedgehog-interacting protein (Hhip) is important in embryogenesis and is known to be a biomarker of several cancers. However, Hhip levels in subjects with diabetes are still unknown. Methods: In total, 314 participants were enrolled and divided into normal glucose tolerance (NGT; n = 75), impaired fasting glucose (IFG; n = 66), impaired glucose tolerance (IGT; n = 86), and newly diagnosed diabetes (NDD; n = 87) groups. Plasma Hhip levels were determined by an ELISA. The association between the Hhip and the presence of diabetes was examined by a multivariate linear regression analysis. Results: There were significant differences in the body mass index, systolic and diastolic blood pressure, fasting plasma glucose (FPG), post-load 2-h glucose, hemoglobin A1c (A1C), C-reactive protein, total cholesterol, triglyceride, and high- and low-density lipoprotein cholesterol levels among the groups. Concentrations of the Hhip were 2.45 ± 2.12, 4.40 ± 3.22, 4.44 ± 3.64, and 6.31 ± 5.35 ng/mL in subjects in the NGT, IFG, IGT, and NDD groups, respectively. In addition, we found that A1C and FPG were independently associated with Hhip concentrations. Using NGT as a reference group, IFG, IGT, and NDD were all independently associated with Hhip concentrations. Conclusions: Hhip was positively associated with prediabetes and type 2 diabetes mellitus.

TDCS Facilitation of Picture Naming: Item-Specific, Task General, or Neither?

The aim of the present study was to clarify the conditions under which anodal tDCS applied to left hemisphere language sites may facilitate picture naming latencies in healthy young adults. We built upon previous studies by directly testing for item-specific and generalized effects of tDCS through manipulation of item-familiarization and through testing for both online and offline effects of stimulation, in the same paradigm. In addition, we tested for the robustness of these effects by comparing two left hemisphere sites critical for lexical retrieval. Twenty-eight healthy young adults completed two testing sessions receiving either anodal (1.5 mA, 20 min) or sham stimulation (1.5 mA, 30 s) in each session. Half of the participants received tDCS over the left inferior frontal region and the other half over the left posterior superior temporal region. All participants were asked to a name a set of pictures and their response latencies were compared at three time points (before, during, and after the end of stimulation). The stimulus set was constructed so that some items were presented at all time points, some before and after stimulation, and some during stimulation only. A parsimonious linear mixed effects model (LMM) revealed robust repetition priming effects as latencies were reliably faster for previously named items in all conditions. However, active tDCS did not produce any additional facilitation in relation to sham, and even led to slower performance in the IFG group when the stimulated items differed from those tested at baseline and post-test. Our findings add to the present debate about the efficacy of single-session tDCS for modulation of lexical retrieval in healthy young adults. We conclude that future research should take a more systematic, step-wise approach to the application of tDCS to the study of language and that more sensitive experimental paradigms, which include a training element, are more adapted to the study of cognitive processes in populations with optimal levels of cortical excitability.

Comparison of health-related quality of Life (HRQOL) among patients with pre-diabetes, diabetes and normal glucose tolerance, using the 15D-HRQOL questionnaire in Greece: the DEPLAN study

BackgroundDiabetes mellitus is usually preceded by a pre-diabetic stage before the clinical presentation of the disease, the influence of which on persons’ quality of life is not adequately elucidated. The purpose of this study was to compare the Health-Related Quality of Life (HRQOL) of persons with pre-diabetes with that of diabetes or normal glucose tolerance (NGT), using the validated HRQOL-15D questionnaire.MethodsThe HRQOL-15D scores of 172 people with pre-diabetes (108 with Impaired Fasting Glucose [IFG], 64 with Impaired Glucose Tolerance [IGT], aged 58.3 ± 10.3 years) and 198 with NGT (aged 54.4 ± 10.1 years) from the Greek part of the DEPLAN study (Diabetes in Europe - Prevention using Lifestyle, Physical Activity and Nutritional Intervention), were compared to 100 diabetes patients’ scores (aged 60.9 ± 12.5 years, diabetes duration 17.0 ± 10.0 years, HbA1c 7.2 ± 1.2%), derived from the outpatient Diabetes Clinic of a University Hospital.ResultsThe diabetes patients’ HRQOL-15D score (0.8605) was significantly lower than the pre-diabetes’ (0.9008) and the controls’ (0.9092) (p < 0.001). There were no differences in the total score between the controls and the group with pre-diabetes. However, examination of individual parameters of the score showed that people with IGT had lower scores compared to the control group, as related to the parameters of “mobility” and “psychological distress”. No differences were found in any component of the HRQOL-15D score between the control group and the IFG group, nor between the two groups with pre-diabetes (IFG vs. IGT).ConclusionsPersons with pre-diabetes had a similar HRQOL score with healthy individuals, and a higher score than persons with diabetes. Specific components of the score, however, were lower in the IGT group compared to the controls. These findings help clarify the issue of HRQOL of persons with pre-diabetes and its possible impact on prevention.

PHS4 - Effect of Fasting Serum Glucose Change on The Risk of Cardiovascular Disease in Men Without Type2 Diabetes

To find the effect of change in fasting serum glucose on the risk of cardiovascular disease without type2 diabetes(T2DM). We analyzed the data of 149,913 Korean men aged ≥40 years without T2DM and history of cardiovascular disease at baseline using National Health Insurance Service database. Participants were first grouped into normal fasting glucose (NFG, 70.0-99.9mg/dL) and impaired fasting glucose (IFG, 100.0-125.9mg/dL) according to the fasting serum glucose levels of the first health screening. Then, the subjects were categorized into five groups which were ≤-25.0, -10.0 to -24.9, -9.9 to 9.9 (a persistent group, reference), +10.0 to +24.9, and ≥+25.0 mg/dL according to change in fasting serum glucose levels between the second and first health screenings. Cox proportional hazards regression analyses were performed to calculate the hazard ratios for the risk of myocardial infarction and stroke after adjusting for potential confounders. Fasting serum glucose increasing ≥25.0mg/dL in the NFG group was associated with an elevated risk of stroke (adjusted hazard ratio, aHR 1.22, 95% confidential interval, CI 1.09-1.37). Fasting serum glucose increasing ≥25.0mg/dL in the IFG group was associated with an elevated risk of myocardial infarction (aHR 1.86, 95% CI 1.25-2.76) and stroke (aHR 1.34, 95% CI 1.09-1.66). Fasting serum glucose decreasing -10.0 to -24.9mg/dL in the NFG group was associated with an elevated risk of stroke (aHR 1.24, 95% CI 1.11-1.38), but decreasing fasting serum glucose in the IFG group was not significantly associated with the risk of myocardial infarction or stroke. Maintaining fasting serum glucose at normal level may contribute to lowering the risk of cardiovascular disease.

Effect of Non-Genetic Factors on Pre-partum Reproduction Traits in Gir Crossbreds

The data on pre-partum reproduction traits viz. age at first conception (AFCon) and age at first calving (AFC) of five groups of Gir crossbred (FG: 50% Holstein Friesian X 50% Gir, IFG:FG Interse, FJG: 50% Holstein Friesian X 25% jersey X 25% Gir, IFJG: FJG Interse and R: 5/8 Gir) maintained at Research-cum-Development Project on cattle, Mahatma Phule Krishi Vidyapeeth (M.P.K.V.), Rahuri Maharashtra (India) were collected from year 1972 to 2015. The effects of period of birth and season of birth on pre-partum reproductive traits were determined by using Harvey’s least-square technique. The overall least-squares means of AFCon in FG, IFG, FJG, IFJG and R group were 530.52 ± 8.35, 761.33 ± 10.66, 531.42 ± 6.60, 722.70 ± 8.64 and 798.06 ± 16.92 days, respectively. The overall least squares means of AFC in FG, IFG, FJG, IFJG and R genetic groups were 810.44 ± 8.41, 1040.64 ± 10.58, 809.88 ± 6.80, 1000.87 ± 8.69 and 1077.74 ± 17.17 days, respectively. The period of birth had significant effect on AFCon and AFC in IFG, FJG and IFJG genetic groups. The effect of season of birth on AFCon and AFC was non-significant in all the genetic groups.

Influence of estrogen-related receptor \u03b3 (ESRRG) rs1890552 A\u2009>\u2009G polymorphism on changes in fasting glucose and arterial stiffness

To determine the effects of the estrogen-related receptor γ (ESRRG) rs1890552 A > G polymorphism on dietary advice-mediated changes in fasting glucose and arterial stiffness, 374 subjects with normal fasting glucose (NFG; control group, no treatment) and 142 subjects with impaired fasting glucose (IFG group, dietary advice) were followed for 3.5 years. At follow-up, the GG subjects in the IFG group showed a significant reduction in fasting glucose, which was greater than in the AA subjects. A significant association was observed between ESRRG rs1890552 A > G polymorphism and changes in fasting glucose, brachial-ankle pulse wave velocity (ba-PWV), and 8-epi-prostaglandin F2α in the IFG subjects. At baseline, the GG subjects showed a higher ba-PWV than the AA subjects in the IFG group. At the 3.5-year follow-up, subjects with AA or AG showed significant increases in ba-PWV, whereas subjects with GG showed a decrease from baseline. This study suggests that the ESRRG rs1890552 A > G polymorphism may modulate interindividual differences in atrial stiffness, with a reduction in fasting glucose in response to dietary advice in subjects with IFG after a 3.5-year follow-up.

Heart‐rate Corrected QT Interval Prolongation in Impaired Fasting Glucose and Type 2 Diabetes: The Polish Norwegian Study (PONS)

IntroductionProlonged QT interval is associated with cardiac arrhythmias and sudden death. Type 2 diabetes mellitus (DM) is associated with increased risk of arrhythmias. Repolarization abnormalities may play a role in increasing the arrhythmic risk in patients with DM.PurposeTo estimate QT interval across the entire spectrum of glucose abnormalities.MethodsCross‐sectional data from an ongoing cohort study, following a standardized protocol. The QT intervals were obtained from digital standard 12‐lead resting ECG. Heart rate correction (QTc) was performed with Bazett's formula. Plasma total, LDL, HDL cholesterol, triglycerides and glucose were measured in a fasting state. We classified glucose metabolism in three categories: normal (no DM and fasting glucose &lt;100 mg/dL), impaired fasting glucose (IFG, no DM and fasting glucose between 100–125.9 mg/dL) and diabetes (history of diabetes or antidiabetic medication or fasting glucose &gt;= 126 mg/dL). We considered as normal, QTc values &lt; 430 ms for men and &lt; 450 ms for women. After excluding medication known to influence the QT interval (antiarrhythmics, digoxin, antipsychotics), the analytic sample size was 11068 participants, ages 45 to 64 years. Multivariable linear and logistic models were used for analyses.ResultsMean (SD) QTc was 413.60 ms (27.37) for men and 421.40 (23.97) ms for women. The overall prevalence of IFG was 23.74% and of DM was 8.43%. The mean (95%CI) QTc was 417.72 ms (417.14–418.30) in the normal glycemic group, 419.88 ms (418.90–420.86) in the IFG group and 424.70 ms (423.06–426.34) in the DM group. After adjustment for age, sex, prevalent cardiovascular disease, hypertension, left ventricular hypertrophy and BMI, these QTc means were 418.06 ms (417.47–418.64), 419.38 ms (418.39–420.37) and 423.45 ms (421.77–425.13) respectively. The likelihood of a higher than normal sex‐specific, age‐adjusted QT interval was 79% higher in those with IFG (OR 1.79, 95% CI 1.50–2.14), compared to those with normal glucose metabolism. After additional adjustment for prevalent cardiovascular disease, hypertension, left ventricular hypertrophy and BMI, these figures remained statistically significant (IGF: OR 1.19, 95% CI 1.04–1.40), DM: OR 1.57, 95%CI 1.30–1.88). History of DM or current antidiabetic drug use was associated with a 46% increase in the odds of a higher than normal sex‐specific QTc interval (OR, 95% CI 1.46, 1.20–1.79), after multivariable adjustment. Among normal glucose and IFG groups, each one additional cardiovascular risk factor increased the likelihood of a higher than normal QTc by 15% (OR, 95% CI 1.11–1.23). However, this effect was not present among those with diabetes. Diabetes duration and/or glucose control in diabetics, was not associated with QTc.ConclusionWe found a progressively increasing QTc interval from normal glucose to IFG and diabetes. Our results suggest that abnormalities in glucose metabolism impact ventricular repolarization, independent of the presence of other cardiovascular risk factors accompanying the diabetic state.Support or Funding InformationThe data collection was supported by a grant from the Polish‐Norwegian Research Fund (PNRF‐228‐AI‐1/07)

Comprehensive assessment of lipoprotein subfraction profiles according to glucose metabolism status, and association with insulin resistance in subjects with early-stage impaired glucose metabolism

BackgroundEarly detection of atherogenic dyslipidemia is crucial. We investigated lipoprotein subfraction parameters according to glucose metabolism status. MethodsWe recruited 1255 lipid-lowering drug-naïve subjects with normal fasting glucose (NFG; n=200, 15.9%), impaired fasting glucose (IFG; n=443, 35.3%), or type 2 diabetes (T2D; n=612, 48.8%). Lipoprotein subfractions (1–7) were determined by polyacrylamide gel electrophoresis, separating low-density lipoprotein (LDL) into large buoyant LDL (lbLDL, LDL1–2) and small dense LDL (sdLDL, LDL3–7). Lipoprotein subfraction parameters including the sdLDL% (LDL3–7/LDL1–7), the sdLDL/lbLDL ratio (LDL3–7/LDL1–2), and weighted LDL subfraction (LDLSF) scores, were compared between groups. Their associations with insulin resistance, estimated using the homeostasis model assessment of insulin resistance, were examined. ResultsThe concentrations of sdLDL particles were significantly higher in subjects with T2D and IFG than in those with NFG (15.78±13.47mg/dl and 14.60±14.33mg/dl, respectively, vs. 12.22±12.31mg/dl). Compared with those with NFG, subjects with IFG or T2D had significantly a higher sdLDL% (15.98±15.26% vs. 19.50±16.21% or 21.46±16.81%, respectively), a higher sdLDL/lbLDL ratio (0.24±0.30 vs. 0.31±0.37 or 0.35±0.39), and a higher LDLSF score (2.08±0.91 vs. 2.30±1.14 or 2.36±1.17). These lipoprotein subfraction parameters had stronger associations with insulin resistance compared to conventional lipid profiles in the IFG and T2D groups. ConclusionsAtherogenic dyslipidemia is initiated in an early stage of impaired glucose metabolism, when early intervention might be required.

The prediction roles of asymmetric dimethyl-arginine, adiponectin and apelin for macroangiopathy in patients with impaired glucose regulation

PurposeTo investigate the effects of asymmetric dimethyl-arginine (ADMA), adiponectin (APN) and apelin in predicting macroangiopathy in impaired glucose regulation (IGR) patients. MethodsA total of 210 patients undergoing oral glucose tolerance test were included in this study. They were classified to normal glucose tolerance (NGT, n=42), impaired fasting glucose (IFG, n=36), impaired glucose tolerance (IGT, n=92, including 44 IGT1 and 48 IGT2 patients) and IFG+IGT (n=40) groups. APN, apelin and ADMA levels, blood pressure, blood lipid, insulin, body mass index (BMI), and homeostasis model assessment of insulin resistance (HOMA-IR) were detected. The severity and extent of coronary atherosclerosis were determined by the Gensini score. ResultsThe prevalence of coronary heart disease and Gensini scores in IGT and IFG+IGT groups were similar but both were higher than NGT and IFG groups (all P<0.05). Lower APN, higher ADMA and apelin levels were witnessed in IGT and IGT+IFG groups compared with NGT and IFG groups (all P<0.05). IGT2 group had higher 2-h PG and apelin levels and Gensini scores but lower APN levels than IGT1 group (all P<0.05). Gensini score was positively correlated with apelin (r=0.669) and ADMA (r=0.764), but were negatively correlated with APN (r=–0.555, all P<0.001). ADMA and APN were the independent factors affecting Gensini score. ConclusionADMA and APN levels could be predictive factors for macroangiopathy in IGR patients, especially in IGT cases.

Usefulness of pulse wave velocity as an indicator of atherosclerosis in subjects with impaired fasting glucose

Background: The prediabetic state with impaired fasting glucose level (IFG) is one of the risk factors for endothelial dysfunction leading to atherosclerosis. Pulse wave velocity is an effective index of arterial stiffness and is widely used for noninvasive assessment of atherosclerosis. Aims and Objectives: To assess the usefulness of pulse wave velocity (PWV) as an indicator of atherosclerosis in IFG. Also to compare PWV values in subjects with IFG and those with normal fasting glucose (NFG) levels and to correlate the PWV values with the fasting glucose levels. Materials and Methods: Two hundred male subjects were involved in the study. Group 1 comprised subjects with IFG (n = 100). Group 2 comprised subjects with NFG (n = 100). Both the groups were evaluated for physiological parameters-Blood pressure and brachial-ankle pulse wave velocity (ba-PWV) using PeriScope. The biochemical parameters such as fasting blood glucose, HbA1c, and lipid profile were also measured. Statistical analysis was done using SPSS-19 software. All parameters were compared using unpaired Student’s t-test. Pearson correlation analysis was done to establish the relationship between two variables. Results: Significant differences were found between the ba-PWV values in the IFG and NFG groups (1549.5 ± 60.5 cm/s vs 1351.7 ± 44.0 cm/s, p < 0.05). There was also significant positive correlation (r = 0.88) between ba-PWV value and fasting glucose level. The multiple regression analysis showed that IFG level is an independent risk factor for increased ba-PWV levels. Conclusion: Our study showed that ba-PWV can be used as an indicator to detect the early development of atherosclerosis in subjects with IFG levels.

Rational diagnoses of diabetes: the comparison of 1,5-anhydroglucitol with other glycemic markers.

Diabetes mellitus (DM) is a frequently encountered disease with important morbidity and mortality. The aim of this study is to document the importance of 1,5-anhydroglucitol (1,5-AG) for the diagnosis of prediabetes and DM, as well as to compare the 1,5-AG with other glycemic markers in order to understand which one is the better diagnostic tool. Between April 2012 and December 2012, 128 participants enrolled in the study. Participants were split into five groups that are IFG, IGT, IFG+IGT, diabetic and control groups by their OGTT results. The diagnostic value of markers was compared by ROC (receiver operating characteristic) method. The mean serum 1,5-AG levels in the diabetic group (33.38 nmol/ml) were lower than, IFG (59.83 nmol/ml), IGT (54.44 nmol/ml), IFG+IGT (51.98 nmol/ml) and control groups (73.24 nmol/ml). When analyzed in the total study population serum 1,5-AG levels did not differ by gender significantly. When analyzed in the total study population, 1,5-AG correlates inversely with age significantly (p = 0.036). In subgroup analysis, in the control group, serum 1,5-AG level was also inversely correlated with age (p = 0.087). The best marker for the diagnosis of prediabetes and DM was fasting plasma glucose (FPG). 1,5-AG was not found to be effective for the diagnosis of DM. This study, contributes to our knowledge of the efficiency and cut-off values of 1,5-AG for the diagnosis of prediabetes and DM. In future, there is a need for larger studies with more standardized and commonly used measurement methods for 1,5-AG, in order to evaluate the efficiency of 1,5-AG for the diagnosis of prediabetes and DM.

Abstract P337: Association of Glucose Intolerance and Insulin Resistance with Incident Cardiovascular Disease in a Japanese Urban Cohort: The Suita Study

Introduction: Glucose intolerance and insulin resistance are known risk factors for cardiovascular disease (CVD). However, few prospective studies were reported the association between combinations of these two factors and incident CVD. We assessed the hypothesis that insulin resistance increased the association between glucose intolerance and CVD in Japanese general population. Methods: We studied 4,638 Japanese individuals (mean age 56.1 years, without CVD) who completed a baseline medical examination and a 75g oral glucose tolerance test in the Suita Study. Glucose categories were defined as follows: diabetes mellitus (DM; fasting plasma glucose levels [FPG] ≥126 mg/dL, 2 hours post-loaded glucose levels [2h-PG] ≥ 200 mg/dL, and/or DM medication); impaired glucose tolerance (IGT; FPG &lt;126 mg/dL and 2h-PG =140-199 mg/dL); impaired fasting glucose (IFG; FPG =100-125 mg/dL and 2h-PG &lt;140 mg/dL); and normal glucose tolerance [NGT]. Insulin resistance was the following formula: HOMA-IR = [FPG] x [fasting insulin] / 405. Insulin resistance was defined as HOMA-IR ≥2.5. Multivariable-adjusted Cox proportional hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated after adjusting for age, sex, body mass index, blood pressure category, hyperlipidemia, smoking, and drinking at the baseline. Results: During the 11.7-year follow-up, we documented 127 cerebral infarctions, 63 hemorrhagic stroke, 12 unclassified strokes, and 143 coronary heart disease events. The adjusted HRs (95% CIs) of subjects with FPG =100-125 mg/dL and ≥126 mg/dL were 1.38 (1.01-1.89) and 2.00 (1.12-3.58) for stroke and 1.47 (0.99-2.19) and 2.73 (1.43-5.22) for cerebral infarction, respectively, compared with the fasting NGT group. On the basis of the subjects with 2h-PG &lt;140 mg/dL group, the adjusted HRs (95% CIs) of subjects with 2h-PG ≥200 mg/dL were 1.71 (1.07-2.72) for stroke and 2.06 (1.20-3.54) for cerebral infarction. Compared to the NGT group, the adjusted HRs (95% CIs) of the subjects with IFG, IGT, and DM were 1.59 (1.10-2.30), 1.34 (0.89-2.00), and 1.86 (1.16-3.00) for stroke and 1.82 (1.13-2.90), 1.55 (0.93-2.56), and 2.43 (1.39-4.26) for cerebral infarction, respectively. Compared to the subjects with HOMA-IR &lt;1.5, the adjusted HRs (95% CIs) of CVD and stroke with HOMA-IR ≥2.5 were 1.45 (1.07-1.96) and 1.61 (1.07-2.42), respectively. Compared to the NGT group without insulin resistance, the IFG and DM groups with insulin resistance were observed the increased risks of stroke (HRs [95% CIs]; 2.05 [1.17-3.57] and 2.11 [1.17-3.83]) and cerebral infarction (HRs [95% CIs]; 2.45 [1.20-5.00] and 3.56 [1.84-6.88]), respectively. Conclusions: Fasting glucose intolerance and insulin resistance are predictive factors for the incidence of stroke and cerebral infarction. Insulin resistance increased the risks of incident stroke and cerebral infarction in general inhabitants with IFG and DM.

Correlation of the incretin effect with first- and second-phase insulin secretions in Koreans with various glucose tolerance statuses.

To examine the relationship between beta-cell function and the incretin effect. We performed a 180-min hyperglycaemic clamp study with oral glucose administration at 60 min in Korean subjects with normal glucose tolerance (NGT, n = 9), impaired fasting glucose (IFG, n = 6) and type 2 diabetes mellitus (T2DM, n = 6). First- and second-phase insulin secretions were measured during the first 60 min. The insulin response to intravenous glucose during the 60- to 120-min interval (Insiv) was calculated using a prediction method. The insulin response to oral glucose (Ins(oral)) was calculated by subtracting the Insiv from the overall insulin response during the 60- to 120-min interval (Ins(overall)). The incretin effect under the hyperglycaemic clamp condition (IE(clamp)) was calculated by the equation: 100 × [(Ins(overall) - Insiv)/Ins(overall)]. The IE(clamp) was comparable among the three groups (46.3 ± 6.4%, 35.7 ± 8.8% and 51.4 ± 7.4% for the NGT, IFG and T2DM group, respectively, P = 0.327) and was not correlated with the first- and second-phase insulin secretions. However, the Ins(oral) (mU/l 60 min) was significantly different between the NGT, IFG and T2DM groups (5199 ± 1185, 2164 ± 956 and 1034 ± 355, respectively; P = 0.010) and was well correlated with the first- and second-phase insulin secretions. The incretin effect measured by the hyperglycaemic clamp with oral glucose loading was neither correlated with beta-cell function nor different between NGT, IFG and T2DM groups in Koreans.

Impaired fasting blood glucose and circulating endothelial progenitor cell function (1072.4)

Impaired fasting blood glucose (IFG: 100‐125 mg/dL) is a risk factor for type 2 diabetes and confers cardiovascular risk. Functional impairment of circulating endothelial progenitor cells (EPCs) is linked to atherogenesis. We tested the hypothesis that IFG is associated with EPC dysfunction. Peripheral blood samples were collected from 22 adults (19 M/3 F): 10 normal fasting glucose (NFG; age: 57±3 yr; BMI: 29.7±1.4 kg/m2; glucose: 90±1 mg/dL) and 12 IFG (59±1 yr; 28.6±1.1 kg/m2; 104±1 mg/dL). Cells with phenotypic putative EPC characteristics were isolated from peripheral blood mononuclear cells and EPC clonogenic (colony forming unit [CFU] assay) and migratory (Boyden chamber) capacity as well as apoptotic susceptibility (intracellular active caspase‐3 concentrations) and angiogenic growth factor release (ELISA) were determined. EPC colony forming capacity was ~60% lower (p&lt;0.05) in the IFG (10±3) vs NFG (23±6) group. Basal (0.31±0.1 vs 0.21±0.1 ng/mL) and staurosporine‐stimulated (2.9±0.3 vs 2.1±0.3 ng/mL) active caspase‐3 levels were markedly (~45%; p&lt;0.05) higher in EPCs from IFG compared with NFG adults. There were no significant differences in EPC migration or release of angiogenic factors. These results suggest that impaired fasting glucose adversely affects the ability of EPCs to form colonies and resist apoptosis, potentially contributing to the increased cardiovascular risk with hyperglycemia.

Correlation between mean platelet volume and blood glucose levels after oral glucose loading in normoglycemic and prediabetic Japanese subjects.

Mean platelet volume (MPV) reflects platelet activity, and high MPV is associated with thrombogenic activation and increased cardiovascular disease risk. Although a positive correlation between MPV and fasting plasma glucose (FPG) levels has been reported, the correlation between MPV and postprandial glucose levels remains unclear. The purpose of the present study was to evaluate the correlation between MPV and postprandial glucose levels in prediabetic and normoglycemic participants. We evaluated 1,080 Japanese participants who underwent the 75-g oral glucose tolerance test (OGTT). Based on these results, the participants were divided into three groups: normal glucose tolerance group (NGT; n=582), impaired fasting glucose group (IFG; n=205) and impaired glucose tolerance group (IGT; n=252). The relationship between MPV, FPG, and postchallenge glucose levels after 1h (1h-PG) and 2h (2h-PG) were analyzed. Bivariate correlation analyses showed a significant positive correlation between MPV and both FPG and 1h-PG levels in the NGT group, as well as between MPV and 2h-PG, total cholesterol, and low-density lipoprotein cholesterol in the IGT group. In contrast, no significant correlation was observed between MPV and postchallenge glucose levels in the IFG group. Multiple correlation analyses showed that FPG levels significantly correlated with MPV in the NGT and IGT groups. In addition, 1h-PG and 2h-PG levels correlated with MPV in the NTG and IGT groups, respectively. These results suggest a possible mechanism by which subjects with postprandial hyperglycemia might be at increased cardiovascular risk.