Impaired Fasting Glucose Research Articles

Triazine herbicides exposure, natural immunoglobulin M antibodies, and fasting plasma glucose changes: Association and mediation analyses in general Chinese urban adults

The effects of triazine herbicides on glucose metabolism remain unclear. In this study, we aimed to assess the associations between serum triazine herbicides and glycemia-related risk indicators in general adults, and to evaluate the mediating role of natural immunoglobulin M antibodies (IgM) in the above associations among uninfected participants. We measured the concentrations of atrazine, cyanazine, and IgM in serum, as well as fasting plasma glucose (FPG), and fasting plasma insulin in 4423 adult participants from the Wuhan-Zhuhai cohort baseline population, enrolled in 2011–2012. Generalized linear models were used to evaluate the associations of serum triazine herbicides with glycemia-related risk indicators, and mediation analyses were performed to evaluate the mediating role of serum IgM in the above associations. The median levels of serum atrazine and cyanazine were 0.0237 μg/L and 0.0786 μg/L, respectively. Our study found significant positive associations of serum atrazine, cyanazine, and Σtriazine with FPG levels, risk of impaired fasting glucose (IFG), abnormal glucose regulation (AGR), and type 2 diabetes (T2D). Additionally, serum cyanazine and Σtriazine were found to be significant positive associated with the homeostatic model assessment of insulin resistance (HOMA-IR) levels. Significant negative linear relationships were observed in associations of serum IgM with serum triazine herbicides, FPG, HOMA-IR levels, the prevalence of T2D, and AGR (P < 0.05). Furthermore, we observed a significant mediating role by IgM in the associations of serum triazine herbicides with FPG, HOMA-IR, and AGR, with the proportions ranging from 2.96% to 7.71%. To ensure the stability of our findings, we conducted sensitivity analyses in normoglycemic participants and found that the association of serum IgM with FPG and the mediating role by IgM remained stable. Our results suggest that triazine herbicides exposure is positively associated with abnormal glucose metabolism, and decreasing serum IgM may partly mediate these associations.

Diabetes Mellitus Control and Chronic Kidney Disease

Chronic kidney disease (CKD) is the rampant onset of diabetes and related complications; chronic kidney disorders and end-stage renal disease are progressing in more than 10% of the world population and mostly affect the elderly, women, minorities and patients with diabetes and hypersensitivity. The early stages of CKD are typically quiet; thus, many people are unaware they have the condition. Data for this review was gathered from Google Scholar, Scopus, PubMed, Elsevier, Cochrane, Sage, Medline, and Web of Science. Studies were selected from 2018-2023, using keywords such as Diabetes mellitus management, chronic kidney disease, microalbuminuria, target time in range, impaired fasting glucose, management ways, lifestyle modification, medication treatment, and diet control. Although blood glucose levels are too unpredictable to provide a reliable evaluation, measures reflecting long-term glycemic load are used instead. The results gathered after the review suggests that optimal glycemic control along with lifestyle medication and diet control contributes to better outcomes in individuals with DM, particularly for microvascular damage. While, HbA1c is the most well-known glycemic biomarker of long-term glycemic management. This suggests that effective treatments are progressing on progression.This review has discussed different CKD management parameters; the authors have discussed the disease’s treatment criteria and protocols, such as pharmacological therapies, lifestyle modifications, physical activities and insulin therapy and concluded that to avoid CKD, it’s critical to concentrate on underlying problems including hyperglycemia, hypertension, microalbuminuria, sedentary behaviour, and smoking. The occurrence of CKD can be reduced with changes in lifestyle, such as increased physical activity, nutritious food, and water consumption.

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression.

Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21-33%), hypertension (32-43%), diabetes (34-47%), and HIV (31-45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa.

Metabolic syndrome and cognitive deficits in the Greek cohort of Epirus Health Study

BackgroundMetabolic syndrome is considered an important risk factor for cognitive decline and dementia. However, the evidence in middle-aged individuals is still conflicting. The aim of the study was to explore the association between metabolic syndrome and its individual components with cognitive function and to investigate possible interaction between sex, age and genetic predisposition for metabolic syndrome and Alzheimer’s disease in a middle-aged Greek cohort.MethodsA total of 2,077 healthy adults (mean age: 46.7 years) were included in the primary cross-sectional analysis and 305 of them in secondary prospective analyses. Metabolic syndrome was defined by the revised National Cholesterol Education-Adult Treatment Panel III and the International Diabetes Federation criteria. Cognitive function was measured primarily with the Trail Making, Verbal fluency and Logical Memory test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, Corsi block-tapping task and Stroop task.ResultsMultivariable linear regressions showed an association of metabolic syndrome with lower performance in attention (β=1.62 seconds, 95% CI=0.20, 3.04) and memory (β=-0.62 words, 95% CI=-1.19, -0.05) that could be driven by associations with elevated fasting glucose and abdominal obesity. Similar associations were observed in the secondary prospective analyses.ConclusionIn summary, metabolic syndrome was associated with cognitive deficits in domains related with the cognitive profile of vascular cognitive impairment.

To cut or not to cut? A prospective randomized controlled trial on short-term outcomes of the uncut Roux-en-Y reconstruction for gastric cancer

BackgroundRoux-en-Y (R-Y) anastomoses have been widely used in distal gastrectomy, while the incidence of Roux stasis syndrome remains common. Uncut R-Y anastomosis maintains the neuromuscular continuity, thus avoiding the ectopic pacemaker of the Roux limb and reducing the occurrence of Roux stasis. However, retrospective studies of Uncut R-Y anastomosis remain scarce and randomized controlled trials have not been reported.MethodsWe conducted a randomized controlled trial to compare the surgical safety, nutritional status, and postoperative quality of life (QOL) between uncut and classic Roux-en-Y (R-Y) reconstruction patients. Patients with Stage I gastric cancer were randomly enrolled and underwent laparoscopic distal gastrectomy followed by uncut or classic R-Y reconstruction. Body mass index and blood test were used to evaluate the nutritional status. QOL was evaluated using European Organization for Research and Treatment of Cancer QOL Questionnaire (STO22) and laboratory examinations at postoperative month (POM) 3, 6, 9, and 12. Computed tomography scanning was used to evaluate the skeletal muscle index (SMI) at POM 6 and 12. Endoscopy was performed at POM 12.ResultsOperation time, blood loss, time to recovery, complication morbidities, and overall survival were similar between the two groups. Compared with the classic R-Y group, the uncut R-Y group displayed a significantly decreased QOL at POM 9, possibly due to loop recanalization, determined to be occupied 34.2% of the uncut R-Y group. Post-exclusion of recanalization, the QOL was still higher in the classic R-Y group than in the uncut R-Y group, despite their hemoglobin and total protein levels being better than those in the classic R-Y group. Preoperative pre-albumin level and impaired fasting glycemia significantly correlated with the postoperative recanalization.ConclusionWe found no significant benefit of uncut over classic R-Y reconstruction which challenges the superiority of the uncut R-Y reconstruction.Trial registrationClinicalTrials.gov Identifier: NCT02644148.

Can orbital artery resistive indexes detect complications of diabetes in the prediabetic phase?

Prediabetic patients have generalized microvascular dysfunction, which leads to end-organ damage, just like diabetes. Therefore, prediabetes is not just a mild elevation in blood sugar, and early detection and prevention of possible complications should be the main goal. Color Doppler imaging (CDI) provides morphologic and vascular information on various diseases. The Resistive Index (RI) is a widely used measure of resistance to arterial flow and is calculated from the CDI. CDI evaluation of vessels in the retrobulbar region may be the first sign of micro- and macrovascular complications. Consecutively, 55 prediabetic patients and 33 healthy subjects were recruited for the study. Prediabetic patients were divided into three groups according to their fasting and postprandial blood glucose values. The groups included an impaired fasting glucose (IFG) group (n = 15), an impaired glucose tolerance (IGT) group (n = 13), and an IFG+IGT group (n = 27). The RI of the ophthalmic artery, posterior ciliary artery, and central retinal artery were measured in all patients. The orbital artery, central retinal artery, and posterior cerebral artery mean RI of prediabetic patients (0.76 ± 0.06, 0.69 ± 0.03, and 0.69 ± 0.04, respectively) were significantly higher than those of the healthy group (0.66 ± 0.04, 0.63 ± 0.04, and 0.66 ± 0.04, respectively; p < 0.001; Student's t-test). The mean ophthalmic artery RI of the healthy, IFG, IGT, and IFG+IGT groups were 0.66 ± 0.39, 0.7 ± 0.27, 0.72 ± 0.29, and 0.82 ± 0.16, respectively, with a significant difference between the groups (p < 0.001, ANOVA). The mean central retinal artery RI of the healthy, IFG, IGT, and IFG+IGT groups were 0.63 ± 0.04, 0.66 ± 0.02, 0.7 ± 0.02, and 0.71 ± 0.02, respectively (p < 0.001, post-hoc Tukey). The mean posterior cerebral artery RI of the healthy, IFG, IGT, and IFG+IGT groups were 0.66 ± 0.04, 0.66 ± 0.04, 0.69 ± 0.03, and 0.71 ± 0.03, respectively, with a significant difference between the groups (p < 0.001 Fisher ANOVA). Increased RI may be the first sign of developing retinopathy, as well as the first sign of microangiopathies occurring simultaneously in the coronary, cerebral, and renal vessels. Precautions to be taken during the prediabetic stage can prevent many possible complications.

Prevalence of glucose metabolism disorders and its association with left atrial remodelling before and after catheter ablation in patients with atrial fibrillation

To investigate the exact prevalence of glucose metabolism disorders, and their impact on left atrial (LA) remodelling and reversibility in patients with atrial fibrillation (AF). We examined 204 consecutive patients with AF who underwent their first catheter ablation (CA). Oral glucose tolerance test was used to evaluate glucose metabolism disorders in 157 patients without known diabetes mellitus (DM). Echocardiography was performed before and 6 months after CA. Oral glucose tolerance test identified abnormal glucose metabolism in 86 patients [11 with newly diagnosed DM, 74 with impaired glucose tolerance (IGT) and 1 with impaired fasting glucose (IFG)]. Ultimately, 65.2% of patients had abnormal glucose metabolism. Diabetes mellitus group had the worst LA reservoir strain and LA stiffness (both P < 0.05), while there was no significant difference in baseline LA parameters between normal glucose tolerance (NGT) group and IGT/IFG group. The prevalence of LA reverse remodelling (≥15% decrease in the LA volume index at 6 months after CA) was significantly higher in NGT group compared with IGT/IFG and DM group (64.1 vs. 38.6 vs. 41.5%, P = 0.006). Both DM and IFG/IGT carry a significant risk of lack of LA reverse remodelling independent of baseline LA size and AF recurrence. Approximately 65% of patients with AF who underwent their first CA had abnormal glucose metabolism. Patients with DM had significantly impaired LA function compared with non-DM patients. Impaired glucose tolerance/IFG as well as DM carries significant risk of unfavourable LA reverse remodelling. Our observations may provide valuable information regarding the mechanisms and therapeutic strategies of glucose metabolism-related AF.

Risk of optic neuritis in type 2 diabetes mellitus: A nationwide cohort study

Background/Purpose:This study aimed to investigate the association between the time course of type 2 diabetes mellitus (DM) and the development of optic neuritis (ON) in the Korean population aged 20 years and older. MethodsA total of 10,069,044 subjects were included in this study, which utilized stratified random sampling from the national cohort. The hazard ratios (HRs) for incident ON were compared between subjects with normal fasting glucose (NFG) levels, impaired fasting glucose (IFG) levels, patients with new-onset DM, diabetes duration of fewer than 5 years (early DM), and diabetes duration of 5 years or more (late DM). In addition, the HR for incident ON was assessed and stratified into 20 fasting glucose levels. ResultsThe cumulative incidence and HR for ON demonstrated a significant increase across the time course of diabetes (adjusted hazard ratio [aHR] = 1.05, 95% confidence interval [CI]: 1.00 to 1.10 for IFG; aHR = 1.31, 95% CI: 1.19 to 1.44 for new-onset DM; aHR = 1.46, 95% CI: 1.32 to 1.60 for early DM; and aHR = 1.92, 95% CI: 1.77 to 2.08 for late DM). Moreover, the HR for ON was 1.71-fold higher in individuals with fasting glucose levels of 132 mg/dL or more compared to those with levels below 75 mg/dL. ConclusionIn this nationwide cohort study, the risk of ON was found to increase with the time course of diabetes and elevated glucose levels. These results suggest that efforts to regulate glucose levels and prevent DM progression could reduce the risk of ON.

Outbred, UM-HET3 mice have greater metabolic and arterial function than inbred, C57BL/6J mice

In recent years, UM-HET3 mice have become more commonly used in biomedical research. UM-HET3 mice are an outbred, genetically diverse strain of mice that is produced by crossing four inbred strains: BALB/cByJ, C57BL/6J, C3H/HeJ, and DBA/2J. Notably, the UM-HET3 strain is used by the National Institute on Aging Interventions Testing Program to investigate treatments that may extend lifespan and delay disease/dysfunction, while minimizing the impact of strain-specific phenotypes that might be observed in inbred, genetically identical strains like the C57BL/6J strain of mice. Here, we sought to examine phenotypic differences between age-matched male and female inbred, C57BL/6J and outbred, UM-HET3 mice (age: 6.4±0.0 mo, n=16 [8M/8F] per group). UM-HET3 had a greater body mass (C57BL/6J: 27±1 vs. UM-HET3: 32±1 g, P&lt;0.05) and tibial length (C57BL/6J: 18.1±0.2 vs. UM-HET3: 19.6±0.3 mm, P&lt;0.05) than C57BL/6J mice. Despite larger body stature, UM-HET3 mice had lower fasting blood glucose (C57BL/6J: 192±6 vs. UM-HET3: 168±5 mg/dL, P&lt;0.05) and lower glucose area under the curve (AUC) in response to glucose tolerance testing (C57BL/6J: 34±1 vs. UM-HET3: 28±2 AU, P&lt;0.05). On the contrary, there were no strain-related differences in glucose AUC in response to insulin tolerance testing (C57BL/6J: 14±1 vs. UM-HET3: 14±1 AU, P&gt;0.05). We also observed no differences in systolic blood pressure (C57BL/6J: 115±2 vs. UM-HET3: 114±2 mmHg, P&gt;0.05), although aortic stiffness, determined by pulse wave velocity (PWV), was lower in UM-HET3 compared to C57BL/6J mice (C57BL/6J: 309±5 vs. UM-HET3: 255±4 cm/sec, P&lt;0.05). Endothelium-dependent dilation (EDD), determined by ex vivo maximal carotid artery dilation to acetylcholine (ACh), was lower in C57BL/6J compared to UM-HET3 (C57BL/6J: 84±2 vs. UM-HET3: 90±1%, P&lt;0.05). In the presence of the nitric oxide (NO) synthase inhibitor, L-NAME, maximal dilation to ACh was similar between groups (C57BL/6J: 38±4 vs. UM-HET3: 34±4%, P&gt;0.05). Thus, NO-mediated dilation, determined by subtracting ACh+L-NAME maximal dilation from ACh maximal dilation, was higher in UM-HET3 compared to C57BL/6J mice (C57BL/6J: 45±3 vs. UM-HET3: 57±4%, P&lt;0.05). We observed no differences in endothelium-independent dilation, determined by ex vivo maximal dilation to sodium nitroprusside (C57BL/6J: 87±1 vs. UM-HET3: 90±2%, P&gt;0.05). In summary, C57BL/6J mice appear to be smaller in stature, but with worse glucose handling, as indicated by impaired fasting glucose and glucose tolerance, compared to UM-HET3 mice. There are also strain differences in arterial function, as aortic stiffness was higher and EDD was lower in C57BL/6J compared to UM-HET3 mice. Strain differences in EDD appear to be due to a reduction in NO-mediated dilation in C57BL/6J mice. Collectively, these data suggest that there are phenotypic differences between these strains, indicating worse metabolic and arterial function in inbred, C57BL/6J compared to outbred, UM-HET3 mice. This study was funded in part by a grant from the National Institutes of Health (R00 AT010017). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Role for insulin sensitivity in the cerebrovascular response to hyperinsulinemia in young adults

Objective: Cerebral blood flow is highly regulated and cerebrovascular responsiveness to vasodilatory stimuli is predictive of brain health. In preclinical animal models, insulin elicits cerebrovascular dilation and subsequent increases in cerebral blood flow. Contrary to this, preliminary data from our group in a large cohort of healthy humans indicate surrogate measures of cerebral blood flow remain at baseline levels during hyperinsulinemia – although responses were highly variable. In the peripheral circulation, insulin-stimulated vasodilation is closely associated with markers of insulin sensitivity (e.g., elevated fasting glucose, insulin, HOMA-IR); whether these associations translate to the cerebral circulation remains unclear. With this information in mind, we hypothesized the degree of insulin-mediated increases in cerebral blood flow would correlate with indices of peripheral insulin sensitivity.Methods: Middle cerebral artery blood velocity (MCAv) was measured with transcranial Doppler ultrasound in 17 adults (11M/6F, 28±2 yrs, 24±1 kg/m 2 ) at baseline and following a 60-min hyperinsulinemic (40 mU/m 2 body surface area/min), euglycemic infusion. Correlations between MCAv and indices of peripheral insulin sensitivity [i.e., fasting glucose, insulin, HOMA-IR, glucose infusion rate, weight, body mass index (BMI), age, physical activity] were determined. Results: Intravenous insulin infusion increased plasma insulin concentrations (6±1 to 49±3 μIU/mL, p&lt;0.001) with blood glucose maintained (73±4 to 82±6 mg/dL, p=0.196). There was no net change in MCAv during hyperinsulinemia (60±4 to 60±4 cm/s, p=0.930). We observed negative associations between the change in MCAv during hyperinsulinemia (Δ=Insulin–Baseline) and both body weight (R=-0.49, p=0.047) and BMI (R=-0.50, p=0.040). No correlations between ΔMCAv and fasting glucose (p=0.435), insulin (p=0.733), HOMA-IR (p=0.960), age (p=0.132), physical activity (p=0.179), or glucose infusion rate (p=0.599) were observed. Conclusions: As previously shown in these participants, hyperinsulinemia in young adults elicits no net change in MCAv. Any increases in MCAv during hyperinsulinemia occur primarily in individuals with lower body weight and lower BMI. Future studies are needed to translate results to disease states (e.g., diabetes). Margaret W. Mangel Faculty Research Catalyst Fund (JP, JKL), NIH HL137769 (JP), NIH HL130339 (JKL) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Abstract #1398611: A High Chemerin: Adiponectin Ratio is Associated with Dysglycemia in Patients with the Polycystic Ovarian Syndrome (PCOS)

PCOS is a multifactorial disease, which in turn increases the chance of progression to Type 2 diabetes (T2D) and metabolic syndrome. Since PCOS is now recognized as the ovarian manifestation of metabolic syndrome, identifying potential biomarkers predictive of glucose intolerance in a subset of PCOS could have important implications for the prevention of T2D in this young population. We observed impaired glucose tolerance (IGT) in PCOS to precede impaired fasting glucose (IFG), indicating impaired insulin-mediated peripheral glucose disposal. Two-hour post-glucose plasma glucose (2h-PGPG), the gold standard protocol to detect IGT, has its limitations, i.e., expensive, labor-intensive, and variability issues. Identifying a biomarker is therefore an unmet need for community studies. Chemerin and Adiponectin are two important organokines that are inversely associated with each other in people with metabolic syndrome (MetS). We looked at Chemerin: Adiponectin ratio as a possible biomarker for glucose intolerance in PCOS. Both fasting plasma glucose and 2h-PGPG were measured biochemically by the GOD-POD method. HbA1c level was measured by HPLC. Serum chemerin and adiponectin levels were measured by ELISA using commercial kits from Cusa-Bio. Serum c-peptide level was used to calculate HOMA2IR and HOMA2β, using ELISA kits from G-Biosciences. Subjects with PCOS with glucose intolerance (PCOS-IGT); median (interquartile range), 26.71 (10.19 - 45.09) [n = 44] showed higher serum chemerin: adiponectin ratio (CAR) compared to controls (PCOS-NGT); median (interquartile range), 6.977 (5.470 - 14.06). CAR correlated positively with 2h-PGPG (r = 0.5347, p < 0.01) and negatively with HOMA-2β (r = -0.5029, p < 0.05). A CAR cut-off value of 14.15 on the ROC curve provided the optimum trade-off between sensitivity and specificity (70.59% and 78.95% respectively). The same cut-off value showed sensitivity and specificity of 76.92%, with an AUC of 0.8964 and likelihood ratio of 3.333, in the case of comparison between PCOS-NGT and PCOS subjects having 2h-PGPG in the diabetic range (PCOS-T2D). With a power (1 – β) of 0.9258, CAR could identify 93% of the subjects having peak plasma glucose levels on OGTT ≥ 140 mg/dL. Moreover, CAR correlated strongly with TG: HDLc ratio (r = 0.62, p < 0.0001). These results suggest that CAR may be utilized as a biomarker for dysglycaemia in the study population. CAR could be a surrogate marker of dysglycaemia in PCOS. The strong correlation between CAR and TG: HDLc ratio is consistent with the premise that lipid abnormalities might precede glucose abnormalities in PCOS, like the situation in metabolic syndrome.

A cross-sectional study on the prevalence of cardiovascular risk factors in police personnel of Karimnagar mandal

Abstract Introduction: Many studies showed that police officers complained about physical and mental health issues due to job stress. These work stresses lead to adopting unhealthy lifestyles and habits including the harmful use of alcohol and tobacco use which leads to high blood pressure, heart attacks, and other NCDs. Methods: This cross-sectional study included all male police personnel of all cadres from nine police stations of Karimnagar Mandal. WHO STEPS NCD survey questionnaires were used to collect basic soci-demographic information, clinical history, stress, and anthropometry for measurements of CVD risk factors. Result: 253 police personnel with a mean age of 41.09 years enrolled from all cadres. 152 (60%) of police personnel had multiple cardiovascular risk factors. Hypercholesterolemia (37.2%) followed by a sedentary lifestyle (30.8%), and diabetes mellitus (14.6%) were important findings in this study. This study has also revealed an important link between preceding conditions for developing cardiovascular diseases such as pre-hypertension in 42.7% and impaired fasting glucose level in 25.7% of police personnel. Half of the study police personnel had a family history of NCDs and it was not statistically significant with service experience. There was a strong association between years of experience and tobacco and alcohol use. Organizational and operational stress levels increased with the increase in years of experience in policing (p-value&lt;0. 01). Conclusion: Smoking and alcohol consumption were more prevalent among Police personnel which need to be controlled. Physical inactivity was another important area. Their attitude towards controlling the risk factors and practicing healthy behavior to safeguard from cardiovascular diseases has to be strengthened. It can be done by conducting regular awareness camps, training sessions, and regular cardiac risk factor evaluations for all police personnel.

Assessment of dietary patterns in obese children and adolescents at risk of pre-diabetes in Basra/Iraq

the role of nutrition in developing pre-diabetes among obese children and adolescents remains a major problem. Method: A cross-sectional study based on food frequency questionnaire data was conducted on obese children and adolescents aged 6

Investigating the association between glycaemic traits and colorectal cancer in the Japanese population using Mendelian randomisation

Observational studies suggest that abnormal glucose metabolism and insulin resistance contribute to colorectal cancer; however, the causal association remains unknown, particularly in Asian populations. A two-sample Mendelian randomisation analysis was performed to determine the causal association between genetic variants associated with elevated fasting glucose, haemoglobin A1c (HbA1c), and fasting C-peptide and colorectal cancer risk. In the single nucleotide polymorphism (SNP)-exposure analysis, we meta-analysed study-level genome-wide associations of fasting glucose (~ 17,289 individuals), HbA1c (~ 52,802 individuals), and fasting C-peptide (1,666 individuals) levels from the Japanese Consortium of Genetic Epidemiology studies. The odds ratios of colorectal cancer were 1.01 (95% confidence interval [CI], 0.99–1.04, P = 0.34) for fasting glucose (per 1 mg/dL increment), 1.02 (95% CI, 0.60–1.73, P = 0.95) for HbA1c (per 1% increment), and 1.47 (95% CI, 0.97–2.24, P = 0.06) for fasting C-peptide (per 1 log increment). Sensitivity analyses, including Mendelian randomisation-Egger and weighted-median approaches, revealed no significant association between glycaemic characteristics and colorectal cancer (P > 0.20). In this study, genetically predicted glycaemic characteristics were not significantly related to colorectal cancer risk. The potential association between insulin resistance and colorectal cancer should be validated in further studies.

Pancreatic fatty replacement as risk marker for altered glucose metabolism and cardiac iron and complications in thalassemia major

ObjectivesThis multicenter study assessed the extent of pancreatic fatty replacement and its correlation with demographics, iron overload, glucose metabolism, and cardiac complications in a cohort of well-treated patients with thalassemia major (TM).MethodsWe considered 308 TM patients (median age: 39.79 years; 182 females) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Magnetic resonance imaging was used to quantify iron overload (IO) and pancreatic fat fraction (FF) by T2* technique, cardiac function by cine images, and to detect replacement myocardial fibrosis by late gadolinium enhancement technique. The glucose metabolism was assessed by the oral glucose tolerance test.ResultsPancreatic FF was associated with age, body mass index, and history of hepatitis C virus infection. Patients with normal glucose metabolism showed a significantly lower pancreatic FF than patients with impaired fasting glucose (p = 0.030), impaired glucose tolerance (p < 0.0001), and diabetes (p < 0.0001). A normal pancreatic FF (< 6.6%) showed a negative predictive value of 100% for abnormal glucose metabolism. A pancreatic FF > 15.33% predicted the presence of abnormal glucose metabolism. Pancreas FF was inversely correlated with global pancreas and heart T2* values. A normal pancreatic FF showed a negative predictive value of 100% for cardiac iron. Pancreatic FF was significantly higher in patients with myocardial fibrosis (p = 0.002). All patients with cardiac complications had fatty replacement, and they showed a significantly higher pancreatic FF than complications-free patients (p = 0.002).ConclusionPancreatic FF is a risk marker not only for alterations of glucose metabolism, but also for cardiac iron and complications, further supporting the close link between pancreatic and cardiac disease.Key Points• In thalassemia major, pancreatic fatty replacement by MRI is a frequent clinical entity, predicted by a pancreas T2* < 20.81 ms and associated with a higher risk of alterations in glucose metabolism.• In thalassemia major, pancreatic fatty replacement is a strong risk marker for cardiac iron, replacement fibrosis, and complications, highlighting a deep connection between pancreatic and cardiac impairment.

Arsenic exposure incurs hyperglycemia mediated by oxidative damage in urban adult population: A prospective cohort study with three repeated measures

The associations and potential mechanisms of low to moderate arsenic exposure with fasting plasma glucose (FPG) and type 2 diabetes mellitus (T2DM) are still unclear. To assess the effects of short-term and long-term arsenic exposure on hyperglycemia and the mediating effect of oxidative damage on such association, three repeated-measures studies with 9938 observations were conducted in the Wuhan-Zhuhai cohort. The levels of urinary total arsenic, FPG, urinary 8-iso-prostaglandin F2alpha (8-iso-PGF2α), urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), and plasma protein carbonyls (PCO) were measured. Generalized linear mixed models were used to evaluate the exposure-response relationships of urinary total arsenic with FPG and the prevalent risks of impaired fasting glucose (IFG), T2DM, and abnormal glucose regulation (AGR). Cox regression models were applied to assess the associations of arsenic exposure with incident risks of IFG, T2DM, and AGR. Mediation analyses were performed to assess the mediating effects of 8-iso-PGF2α, 8-OHdG, and PCO. In cross-sectional analyses, each one-unit increase in natural log-transformed urinary total arsenic was associated with a 0.082 (95% CI: 0.047 to 0.118) mmol/L increase in FPG, as well as a 10.3% (95% CI: 1.4%–20.0%), 4.4% (95% CI: 5.3%–15.2%), and 8.7% (95% CI: 1.2%–16.6%) increase in prevalent risks of IFG, T2DM, and AGR, respectively. In longitudinal analyses, arsenic exposure was further associated with the annual increased rate of FPG with a β (95% CI) of 0.021 (95% CI: 0.010 to 0.033). The incident risks of IFG, T2DM, and AGR were increased without statistical significance when arsenic levels increased. Mediation analyses showed that 8-iso-PGF2α and PCO mediated 30.04% and 10.02% of the urinary total arsenic-associated FPG elevation, respectively. Our study indicated that arsenic exposure was associated with elevated level and progression rate of FPG among general Chinese adults, where lipid peroxidation and oxidative protein damage might be the potential mechanisms.

Acrolein Exposure Impaired Glucose Homeostasis and Increased Risk of Type 2 Diabetes: An Urban Adult Population-Based Cohort Study with Repeated Measures

Acrolein is an identified high-priority hazardous air pollutant ubiquitous in daily life and associated with cardiometabolic risk that attracts worldwide attention. However, the etiology role of acrolein exposure in glucose dyshomeostasis and type 2 diabetes (T2D) is unclear. This repeated-measurement prospective cohort study included 3522 urban adults. Urine/blood samples were repeatedly collected for determinations of acrolein metabolites (N-acetyl-S-(3-hydroxypropyl)-l-cysteine, N-acetyl-S-(2-carboxyethyl)-l-cysteine; acrolein exposure biomarkers), glucose homeostasis, and T2D at baseline and a three-year follow-up. We found that each 3-fold increment in acrolein metabolites was cross-sectionally associated with 5.91-6.52% decrement in homeostasis model assessment-insulin sensitivity (HOMA-IS) and 0.07-0.14 mmol/L, 4.02-4.57, 5.91-6.52, 19-20, 18-19, and 23-31% increments in fasting glucose (FPG), fasting insulin (FPI), HOMA-insulin resistance (HOMA-IR), risks of prevalent IR, impaired fasting glucose (IFG), and T2D, respectively; longitudinally, participants with sustained-high acrolein metabolite levels had increased risks of incident IR, IFG, and T2D by 63-80, 87-99, and 120-154%, respectively (P < 0.05). In addition, biomarkers of heme oxygenase-1 activity (exhaled carbon monoxide), lipid peroxidation (8-iso-prostaglandin-F2α), protein carbonylation (protein carbonyls), and oxidative DNA damage (8-hydroxy-deoxyguanosine) mediated 5.00-38.96% of these associations. Our study revealed that acrolein exposure may impair glucose homeostasis and increase T2D risk via mediating mechanisms of heme oxygenase-1 activation, lipid peroxidation, protein carbonylation, and oxidative DNA damage.

The Risk of Type 2 Diabetes Mellitus according to Changes in Obesity Status in Late Middle-Aged Adults: A Nationwide Cohort Study of Korea.

Although obesity is a well-known risk factor of type 2 diabetes mellitus (T2DM), there is scant data on discriminating the contribution of previous obesity and recent weight gain on developing T2DM. We analyzed the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 where Korean residents underwent biennial health checkups. Participants were classified into four groups according to their obesity status (body mass index [BMI] ≥25 kg/m2) before and after turning 50 years old: maintaining normal (MN), becoming obese (BO), becoming normal (BN), and maintaining obese (MO). Cox proportional hazards regression model was used to estimate the risk of T2DM factoring in the covariates age, sex, BMI, presence of impaired fasting glucose or hypertension, family history of diabetes, and smoking status. A total of 118,438 participants (mean age, 52.5±1.1 years; men, 45.2%) were prospectively evaluated for incident T2DM. A total of 7,339 (6.2%) participants were diagnosed with T2DM during a follow-up period of 4.8±2.6 years. Incidence rates of T2DM per 1,000 person-year were 9.20 in MN, 14.81 in BO, 14.42 in BN, 21.38 in MO. After factoring in covariates, participants in the groups BN (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.04 to 1.27) and MO (aHR, 1.14; 95% CI, 1.06 to 1.24) were at increased risk of developing T2DM compared to MN, whereas BO (hazard ratio, 1.06; 95% CI, 0.96 to 1.17) was not. Having been obese before 50 years old increased the risk of developing T2DM in the future, but becoming obese after 50 did not. Therefore, it is important to maintain normal weight from early adulthood to prevent future metabolic perturbations.

Reduced platelet-lymphocyte ratio in a Saudi population with impaired fasting glycemia and hyperglycemia

BackgroundDiabetes mellitus (DM) is an inflammatory disorder characterized by elevated fasting blood glucose (FBG) with life-threatening complications. However, the physiological response of peripheral blood cells to impaired fasting glycemia (IFG) and hyperglycemia (HG) is ill-defined. AimIn this report, we investigated the patterns of change in platelet-lymphocyte ratio (PLR) relative to glycemic control. MethodsWBC count, PLR, C-reactive protein (CRP), FBG, HbA1c, and Hb results for 1,793 subjects were retrospectively analyzed. ResultsPLR was significantly reduced in HG compared to IFG and to normoglycemia (NG) while FBG was only significantly lower in males with elevated PLR. Increased PLR was less prevalent in subjects with HG and was a protective factor against HG. Upon stratification by HbA1c, PLR was found to be significantly lower in IFG compared to NG only in females. Importantly, PLR performed better than CRP in discriminating NG and HG in females. ConclusionThis report provides insights into the cellular physiological response to DM and evaluates PLR as a novel marker for DM management.

The Relationship Between Metabolic Syndrome and Benign Prostate Enlargement: A Case-Control Study in a Peruvian Military Hospital.

This study aimed to determine how metabolic syndrome is related to benign prostatic enlargement in males under 60 years old in a national military hospital in Peru. We conducted a retrospective, quantitative, case-control study. By simple random sampling, 87 cases with benign prostatic enlargement and 174 controls were included, with a statistical power of 80%. The benign prostatic enlargement was evaluated by clinical picture and ultrasound and the metabolic syndrome was evaluated according to the Adult Treatment Panel III criteria. The statistical analysis was performed using the STATAv14 program, the chi-square statistical test was used and odds ratio was obtained, at a significance level of 5%. The mean age of the cases and controls was 55 (51-58) and 52 (46-57), respectively. By multivariate analysis, the factors related to benign prostatic enlargement were the presence of benign prostatic enlargement (adjusted odds ratio: 2.71, 95% CI: 1.27-5.80; P=.010), waist circumference ≥102 cm (adjusted odds ratio: 6.51, 95% CI: 3.09-13.71; P < .001), elevated fasting glucose (adjusted odds ratio: 1.38, 95% CI: 0.65-2.91; P=.399), high triglycerides (adjusted odds ratio: 5.29, 95%: CI 2.40-11.64; P < .001), and arterial hypertension (adjusted odds ratio: 4.67, 95% CI 2.19-9.95; P < .001). Elevated high-density lipoprotein cholesterol was a protective factor (adjusted odds ratio: 0.09, 95% CI: 0.04-0.20; P < .001). The present study showed that metabolic syndrome and its components (waist circumference, hypertension, triglycerides, and high-density lipoprotein cholesterol) are factors related to benign prostatic enlargement in patients under 60 years old in a military hospital in Peruvian population. Waist circumference as an indicator of overweight/obesity is a practical anthropometric marker of interest in public health.