Impaired Glucose Levels Research Articles

Correlation of APOE polymorphism, expression, and plasma levels with cardiac comorbidities among lipodystrophy in HIV-infected patients

Lipodystrophy in HIV-infected patients (LDHIV) includes morphological and metabolic abnormalities, including lipid and glucose metabolism. ApoE plays a role in the transport and clearance of lipoprotein. In the general population, ApoE 112 (rs429358) and 158 (rs7412) polymorphisms were linked to severe dyslipidemia. Therefore, we investigated ApoE polymorphism using PCR-RFLP in 200 HIV patients (100 with HIV-associated lipodystrophy (HIVLD), 100 without HIVLD), as well as 100 healthy controls. We also assessed ApoE expression using qRT-PCR and measured its level using ELISA. The APOE 4/4, 3/4, and 2/4 genotypes have been associated with a decreased risk of HIV-1 infection. (P = 0.0001, OR = 0.18; P = 0.006, OR = 0.87; P = 0.006, OR = 0.09) when compared between HIV-positive individuals and healthy controls. Conversely, APOE allele 2 was linked to a higher risk of acquiring HIV-1 (P = 0.03, OR = 3.02). APOE allele 2 was linked to a higher likelihood of HIVLD severity when compared between patients with and without HIVLD (P = 0.05, OR = 2.82). When comparing patients with HIVLD to healthy controls, the APOE 4/4 and 2/4 genotypes as well as allele 4 were linked with the reduced risk of LDHIV (P = 0.0006, OR = 0.21; P = 0.01, OR = 0.18; P = 0.0002, OR = 0.40). When compared to patients without HIVLD from healthy controls, the ApoE 4/4 genotype, 2 and 4 alleles, were linked to a reduced risk of developing HIVLD (P = 0.0009, OR = 0.14; P = 0.0001, OR = 0.17; P = 0.00001, OR = 0.39). When comparing impaired to normal cholesterol levels in patients without HIVLD, the ApoE 3/4 genotype was linked with the increased risk of impaired cholesterol levels (P = 0.02, OR = 3.37). When comparing impaired and normal glucose levels in patients without HIVLD, the ApoE 4/4 genotype was associated to an elevated risk of impaired glucose levels (P = 0.03, OR = 8.27). In multivariate analysis, independent impaired cholesterol, LDL, and glucose levels were associated with a higher risk of lipodystrophy severity (P = 0.04, OR = 2.33; P = 0.001, OR = 4.05; P = 0.05, OR = 2.63). ApoE expression was up-regulated in LDHIV with a fold change value of 4.02 compared to those without HIVLD. ApoE protein level was found to be higher in patients of the HIVLD group (3.01 mg/dL) compared to those without HIVLD group (2.83 mg/dL). In conclusion, individuals with ApoE allele 2 were at higher risk for HIV-1 acquisition and severity of HIVLD, whereas those with ApoE allele 4 were at reduced HIVLD severity and development risk. It’s possible that ApoE’s increased level and its overexpression are related to the ApoE allele 2 in HIVLD patients. The development of LDHIV may be facilitated by the APOE 3/4 and 4/4 genotypes as well as abnormal glucose and cholesterol levels.

3D printing and bioprinting in the battle against diabetes and its chronic complications.

Diabetes is a metabolic disorder characterized by high blood sugar. Uncontrolled blood glucose affects the circulatory system in an organism by intervening blood circulation. The high blood glucose can lead to macrovascular (large blood vessels) and microvascular (small blood vessels) complications. Due to this, the vital organs (notably brain, eyes, feet, heart, kidneys, lungs and nerves) get worsen in diabetic patients if not treated at the earliest. Therefore, acquiring treatment at an appropriate time is very important for managing diabetes and other complications that are caused due to diabetes. The root cause for the occurrence of various health complications in diabetic patients is the uncontrolled blood glucose levels. This review presents a consolidated account of the applications of various types of three-dimensional (3D) printing and bioprinting technologies in treating diabetes as well as the complications caused due to impaired blood glucose levels. Herein, the development of biosensors (for the diagnosis), oral drug formulations, transdermal drug carriers, orthotic insoles and scaffolds (for the treatment) are discussed. Next to this, the fabrication of 3D bioprinted organs and cell-seeded hydrogels (pancreas engineering for producing insulin and bone engineering for managing bone defects) are explained. As the final application, 3D bioprinting of diabetic disease models for high-throughput screening of ant-diabetic drugs are discussed. Lastly, the challenges and future perspective associated with the use of 3D printing and bioprinting technologies against diabetes and its related chronic complications have been put forward.

Mediterranean Diet Combined with Regular Aerobic Exercise and Hemp Protein Supplementation Modulates Plasma Circulating Amino Acids and Improves the Health Status of Overweight Individuals.

Plant protein is considered a sustainable health-promoting strategy to prevent metabolic syndrome. Lifestyle changes (including dietary patterns and exercise) have been demonstrated to exert an effect on human health by modulating the biochemical status in humans. The objective of this study was to assess whether supplementation with hemp protein within a Mediterranean diet context together with exercise could help to ameliorate the metabolic statuses of patients prone to developing metabolic syndrome. For this study, 23 patients followed with Mediterranean diet and engaged in aerobic exercise according to the WHO's recommendations, while also being supplemented with hemp protein, for 12 weeks. A comparison of anthropometric, biochemical, and mineral data as well as amino acid values was made between the start and the end of the study, with the subjects acting as their own control group. Statistical analyses included a paired t-test, Wilcoxon paired test, Pearson correlation coefficient, and Sparse Partial Least Squares Discriminant Analysis to evaluate significant differences and correlations among parameters. There were statistically significant changes in total cholesterol, HDL-C (+52.3%), LDL-C (-54.0%), and TAG levels (-49.8%), but not in glucose plasma levels. Following the intervention, plasma concentrations of some amino acids, including α-aminoadipic acid, phosphoethanolamine, and 1-metylhistidine, increased, whereas those of asparagine and alanine declined. Different correlations between amino acids and the other parameters evaluated were reported and discussed. A Mediterranean diet combined with regular aerobic exercise, together with protein supplementation, can highly improve the metabolic parameters and anthropometric parameters of subjects with obesity and impaired glucose levels, ameliorating their health status and likely delaying the development of metabolic syndrome.

Glomerular Filtration Rate in Prediabetic Subjects in Kendari City

Prediabetes is a condition of impaired blood glucose metabolism. However, it does not yet meet the criteria for diabetes mellitus, characterized by impaired fasting blood glucose (FBG) levels and the Oral Glucose Tolerance Test (OGTT). Chronic glucose intolerance can increase the workload of the kidney glomerulus in the filtration process and the tubules in the reabsorption process. The research aims to assess the Glomerular Filtration Rate (GFR) in prediabetic subjects in Kendari. This type of analytical observational research with a case-control design. The total sample was 90 samples consisting of 45 non-diabetic samples as the control group and 45 prediabetic samples as the case group. Characteristic data is presented as a frequency distribution and test data for differences between the control group and cases using an independent t-test with statistical test results said to be significant if the p-value is less than 0.05. The research results showed that the frequency distribution of subjects in the control group and cases based on gender was dominated by women, with the most extensive age range being 36-55 years. The FBG variable in the control group had a mean of 94±5.31 mg/dL, and in the case group, 110±8.09 mg/dL. The OGTT value in the control group was 118±12.78 mg/dL, and the case group was 139±23.90 mg/dL. The results of the calculation of the GFR showed a mean of 98.63±14.28 mL/min/1.73 m2 in the control group and 50.10±16.34 mL/min/1.73 m2 in the case group, different significant (p equal 0.000). There was a significant difference between GFR in the control group and the prediabetes case group. The results of the GFR assessment in the prediabetes group showed a mild decrease in renal function.

Relationship between manganese minerals and type 2 diabetes mellitus: A mini review

Indonesia is the fourth country with the largest prevalence of DM in the world which is caused by an unhealthy lifestyle. Risk factors for DM that cannot be modified include race, ethnicity, age, gender, genetics from a family with DM, history of giving birth >4 kg and LBW <2.5 kg. Meanwhile risk factors that can be modified include overweight, abdominal/central obesity, lack of physical activity, high blood pressure (hypertension), dyslipidemia, high calorie and unbalanced diet, prediabetes with impaired blood glucose tolerance levels (IGT 140 -199 mg/dl) or impaired fasting blood glucose levels (GDPT <140 mg/dl) as well as smoking habits. Several studies have revealed that dietary manganese is related to type 2 DM. However, the relationship between manganese diet and type 2 DM in women cannot yet be explained through a definite pathophysiological pathway after all confounding variables have been adjusted for, so it still needs to be studied further, especially regarding manganese analysis methods in assessing manganese status. which is usually based on the concentration of manganese in plasma/serum and all blood components.

HEALTH AND FUNCTION FROM MID LIFE TO LATE ADULTHOOD: FINDINGS FROM THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN)

Abstract Midlife (age 40-64) is characterized by physiologic, psychosocial and situational change, and a time when women experience the seminal endocrinological event of menopause. From a lifecourse perspective, understanding the relationship between midlife and older adult health is critical, particularly for identifying modifiable factors in midlife that impact later life health and functioning. Previous research has demonstrated that midlife health and functioning is dynamic and thus potentially amenable to intervention, though there remain crucial gaps in our understanding of this period. The Study of Women’s Health Across the Nation (SWAN) is an observational multi-racial/ethnic (White, Black, Chinese, Japanese, Hispanic) longitudinal study of 3,302 women recruited in 1996 from 7 sites in the United States (Boston, MA; Newark, NJ; Pittsburgh, PA; Detroit-area, MI; Chicago, IL; Oakland, CA; Los Angeles, CA). Over the past 27 years, women have participated in up to 17 near-annual study visits, spanning from midlife (age 42-52 years at baseline) to later life (age 69-79 years). This symposium features new science from SWAN including: an examination of rate of change in depressive symptoms across the menopausal transition (Avis); the impact of impaired glucose levels in midlife on muscle quality and power (Leis); the importance of sleep regularity for cognitive function (Derby); and the association of urinary incontinence with disability (Dugan). The symposium provides information regarding data and biospecimen access for investigators interested in using SWAN resources (Brooks). The Discussant will consider the implications of studying midlife health and function in relation to health and well-being in late adulthood.

Frequency of diabetes mellitus in patients with chronic Hepatitis C Infection

Diabetes and hepatitis C infection are prevalent worldwide. The one chronic disease the later communicable disease is associated as far mortality is concern. People with hepatitis C infection are prone to develop type 2 diabetes. Objective: To find out the frequency of diabetes mellitus in chronic hepatitis C infected patients admitted to Department of Medicine, Khyber Teaching Hospital KPK. Methods: A cross-sectional Descriptive Study was conducted having 104 patients aged 15 years and above from both genders in department of Medicine for a duration of one year from 2nd March 2020 to 26th February 2021.The inclusion criteria were set for patients who were hepatitis C positive for at least two months investigated through detection of HCV antibodies by ELISA. Chronic hepatitis C was diagnosed on the basis of detecting HCV antibodies by ELISA, and confirmed by detecting HCV RNA by polymerase chain reaction (PCR). Diabetes mellitus was diagnosed on the basis of random blood sugar above 200 mg/dL, fasting blood sugar above 126 mg/dL on two occasions or HBA1C above 6.5 % (diagnostic criteria designed by ADA). Results: Only 21 (21%) were found to have newly diagnosed diabetes mellitus with a p value 0.37. Those with impaired glucose levels were found in 15(15%), and 59(59%) were with normal glucose level. Conclusions: Our study did not find any statistical significance in our result with p-value= (0.37).

Comorbidities and New Onset of Type 2 Diabetes Mellitus among Women Living with HIV Receiving Antiretroviral Therapy in Lagos, Nigeria

Background: There is limited gender stratified data in many type 2 diabetes mellitus (T2DM) studies in Africa. This study aimed to determine the prevalence of Comorbidities, New Onset of T2DM and risk factors influencing predisposition to T2DM among women living with HIV (WLWH) and receiving Antiretroviral Therapies. Methods: This was a cross-sectional study of females who were 15 years and above with HIV and/or without pulmonary TB attending HIV and TB DOTS clinics in Lagos, Nigeria from January 2019 to October 2021. The socio-demographic data of participants were obtained using questionnaire. Participants who were not known diabetic cases were tested for diabetes based on WHO and ADA standards using glycated haemoglobin (HbA1c) test, fasting plasma glucose and 2 hour 75 g oral glucose post prandial test. CD4 and CD8 counts were carried out using flow cytometer and their cytokines’ levels were determine using ELISA technique. HIV positive patients with signs and symptoms of TB (presumptive TB) were tested using sputum smear microscopy method and gene X-pert technique. We measured Body mass index (BMI) using International System of Units (kg/m2). Information on age, gender, Antiretroviral therapy (ART), values of CD4, weight, height, viral load and cholesterol test results less than 6 months were obtained from the patients’ folders. Results: A total of 187 WLWH were studied. Their mean age was 41.93±10.32 years. Fifty-five (27.9%) had BMI values of ≥ 30 kg/m2. Twenty-one (11.2%) had impaired glucose level. Those with T2DM at baseline were 5(2.7%), 17(9.1%) later developed T2DM. There was strong association between newly developed T2DM and obesity odd ratio (OR) 8.21(95% CI 1.30-51.99), interleukin (IL-): IL-6 OR 4.50 (95% CI 0.58-35.15), viral load with OR as 1.34(0.48-3.75), knowledge of diabetes OR 2.24 (95% CI 0.43-11.62), consumption of alcohol OR 2.03(95% CI 0.60-6.90). Twenty (10.7%) WLWH developed pulmonary TB while receiving ART. Co-morbidities recorded were: HIV/T2DM 14(7.5%), HIV/TB 21(11.2%), HIV/TB/T2DM 7(3.7%). A total of 42(22.7%) were on 2nd line ART. Conclusion: Prevalence of HIV/TB co-infection, HIV/T2DM comorbidity and HIV/TB/T2DM multimorbidity were high. Also the prevalence of incident TB and new cases of T2DM among the study population were high. There was positive association between development of T2DM while receiving ART and obesity, IL-6, knowledge of diabetes and alcohol consumption. Protease inhibitors were found to influence the development of T2DM among WLWH while receiving ART. Recommendation: There is need for promoting awareness of T2DM and its risk factors among WLWH who are receiving ART.

LBSUN293 Diabetic Hand Infection: A Case Report

Abstract Background Diabetes Mellitus is related to musculoskeletal and soft tissues complications in a very diverse way, and with no doubt, hands are also affected. Almost 40% of people living with Diabetes have significant problems in the hands that require medical attention. (1) Clinical Case: A 59-year-old women with history of Diabetes Mellitus diagnosed 20 years ago without control, treated with NPH and Lispro insulin (basal bolus regimen). She was admitted to the emergency room due to a third-degree boiling water burn in her right index finger. Before she came to the hospital, she was previously evaluated by a physician who prescribed antibiotics (clindamycin) for 5 days without response. At physical examination, erythema, edema, purulent secretion was found in the finger. In addition, fever and high glucose levels were also noted. During hospitalization, intravenous antibiotics such as tigecycline and oxacillin were used with no improvement. Blood samples demonstrated leukocytosis and C-reactive protein (CPR) elevated levels. Secretion culture was positive to Methicillin-sensible Staphylococcus Aureus. Electromyography revealed severe lesions at sensory-motor peripheral nerves with chronic denervation in upper limbs. Due to the poor evolution of the injury, traumatologists indicated surgical cleaning. After 2 days, leukocytosis and CPR elevated levels persisted and despite all the efforts done to save the finger, traumatologists decided to perform an amputation. After 2 weeks of antibiotic treatment, the patient was discharged with normalized hemogram and CPR levels. Conclusion Diabetic hand infection is less recognized in the literature that the diabetic foot, main reason why it is easily ignored and underestimated; resulting in increased morbidity among diabetic patients. The combination of neuropathy, peripheral artery disease and impaired glucose levels made this patient had a poor outcome, resulting in the loss of a finger. It is very important to evaluate the hands during routine controls to avoid these sad events.

Optimization of Early Diagnosis of Glucose Metabolism Impairment for Patients Receiving Antipsychotic Medications at the Outpatient Psychiatric Clinic of the University Teaching Hospital, Lusaka, Zambia

Introduction: Patients using antipsychotic drugs are more likely than the general population to suffer glucose metabolism dysfunctions. Patients who take antipsychotic drugs, particularly second-generation antipsychotics, are four times more likely to develop overweight, obesity, and diabetes type 2. Failing to recognize these metabolic issues puts an individual at risk of developing cardio-metabolic and others disorders that potentially worsen psychiatric problems. For controlling and enhancing potential psychiatric treatment outcomes, early diagnosis and treatment of glucose metabolism dysfunction are crucial. Objective: To optimize the early diagnosis of glucose metabolism impairments in patients with psychiatric disorders treated with antipsychotic medications. Methodology: This is a descriptive cross-sectional study that was conducted at the outpatient psychiatric clinic of the University Teaching Hospital (Lusaka, Zambia). A systematic sampling method was applied to all patients who were receiving antipsychotic drugs. All participants were checked for their weight, height, Body Mass Index (BMI), waist circumference, random, and fasting blood glucose levels respectively. The results were analyzed by using SPSS software (version 20), while Fisher’s exact test was used to determine the relationship between categorical variables. Results: The proportion of individuals with impaired fasting blood glucose levels found in this study was 11.1% and that of individuals with diabetes was 10.0% respectively which is higher compared to the general population. Patients who were receiving second-generation antipsychotics showed a slightly higher proportion of impaired fasting blood glucose levels compared to those on conventional antipsychotic medications. Conclusion: The glucose metabolism deficit in patients with psychotic disorders was found to be high. Patients of both sexes had an equal chance of developing the problem, though females had a higher proportion as compared to males, and it is not time-dependent. Older patients showed a higher proportion of impaired fasting blood glucose levels compared to younger ones. It is recommended that basic screening measures of glucose metabolism parameters that are simple and cost-effective, like checking weight, BMI, waist circumferences, and regular checking of blood glucose levels, be routine practice in all psychiatric settings before starting antipsychotic medications.

Plasma prostasin: a novel risk marker for incidence of diabetes and cancer mortality

Aims/hypothesisDiabetes is associated with an increased risk of cancer. Prostasin is an epithelial sodium channel stimulator that has been associated with suppression of tumours, glucose metabolism and hyperglycaemia-associated tumour pathology. However, the association between prostasin, diabetes and cancer mortality has not been well investigated in humans. We aim to investigate the associations between plasma prostasin and diabetes, and to explore whether prostasin has an effect on cancer mortality risk in individuals with hyperglycaemia.MethodsPlasma prostasin was measured using samples from the Malmö Diet and Cancer Study Cardiovascular Cohort, and statistical analysis was performed from both sex-specific quartiles and per 1 SD. The cross-sectional association between plasma prostasin and diabetes was first studied in 4658 participants (age 57.5 ± 5.9 years, 39.9% men). After excluding 361 with prevalent diabetes, the associations of prostasin with incident diabetes and cancer mortality risk were assessed using Cox regression analysis. The interactions between prostasin and blood glucose levels as well as other covariates were tested.ResultsThe adjusted OR for prevalent diabetes in the 4th vs 1st quartile of prostasin concentrations was 1.95 (95% CI 1.39, 2.76) (p for trend <0.0001). During mean follow-up periods of 21.9 ± 7.0 and 23.5 ± 6.1 years, respectively, 702 participants developed diabetes and 651 died from cancer. Prostasin was significantly associated with the incidence of diabetes. The adjusted HR for diabetes in the 4th vs 1st quartile of prostasin concentrations was 1.76 (95% CI 1.41, 2.19) (p for trend <0.0001). Prostasin was also associated with cancer mortality There was a significant interaction between prostasin and fasting blood glucose for cancer mortality risk (p for interaction =0.022), with a stronger association observed in individuals with impaired fasting blood glucose levels at baseline (HR per 1 SD change 1.52; 95% CI 1.07, 2.16; p=0.019).Conclusions/interpretationPlasma prostasin levels are positively associated with diabetes risk and with cancer mortality risk, especially in individuals with high blood glucose levels, which may shed new light on the relationship between diabetes and cancer.Graphical abstract

Physical Activity Evaluation Using Activity Trackers for Type 2 Diabetes Prevention in Patients with Prediabetes.

Background: Prediabetes is a reversible condition, but lifestyle-changing measures, such as increasing physical activity, should be taken. This article explores the use of Fitbit activity trackers to assess physical activity and its impact on prediabetic patient health. Methods: Intervention study. In total, 30 volunteers (9 males and 21 females), aged 32–65 years, with impaired glucose levels and without diabetes or moving disorders, received Fitbit Inspire activity trackers and physical activity recommendations. A routine blood check was taken during the first and second visits, and body composition was analyzed. Physical activity variability in time was assessed using a Poincare plot. Results: The count of steps per day and variability differed between patients and during the research period, but the change in total physical activity was not statistically significant. Significant positive correlations between changes in lipid values, body mass composition, and variability of steps count, distance, and minutes of very active physical activity were observed. Conclusions: When assessing physical activity, data doctors should evaluate not just the totals or the medians of the steps count, but also physical activity variability in time. The study shows that most changes were better linked to the physical activity variability than the total count of physical activity.

Assessment of diabetes mellitus prevalence among outdoor patient departments in a tertiary care hospital

Diabetes mellitus, affecting the multisystem in human body, is primarily characterized by chronic hyperglycemia. The impaired glucose level may be due either of insulin resistance or insulin secretion that produces micro vascular as well as macro vascular complications in human beings. Diabetes is characterized by excessive thirst, extreme hunger, frequent urination and weight loss. Pre-screening to assess random blood glucose level, before any minor or major procedure is of utmost important for better functional outcome of patients. The aim of this retrospective study was to assess the level of awareness and screening amongst patient visiting in outdoor and indoor department in a tertiary level hospital. The patients which were sent for random blood sugar testing were included in this study from a period of March 2019 to February 2020. Data of random blood sugar level of 3750 patients were scrutinized and collected from 75000 records and analyzed by Excel software for correlation and association. Keeping statistical significance of P &lt; 0.05, the prevalence of diabetes mellitus was found to be 33.4% in tested random blood sugar levels. This study has shown more prevalence in male (m=2325, 62%) with higher incidence in age group in 41-60 years (48.4%).

Plasma random glucose levels at hospital admission predicting worse outcomes in STEMI patients undergoing PCI: A case series

BackgroundThe effects of impaired plasma glucose levels on predicting clinical outcomes and in-hospital events in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is unknown. Therefore, we evaluated random blood glucose at admission and its association with clinical outcomes in STEMI patients treated with PCI. MethodsPatients with STEMI undergoing PCI were enrolled and were divided into 4 tertiles according to random blood glucose levels. Tertile 1 had levels below 100 mg/dL, tertile 2 had 100–200 mg/dL, tertile 3 had 200–300 mg/dL, and tertile 4 had random blood glucose levels >300 mg/dL. The cumulative rates of in-hospital mortality and major adverse cardiovascular events were calculated. ResultsBoth the incidence of all-cause deaths and cumulative rates of major adverse cardiovascular events were significantly the lowest in patients within tertile 1. The cumulative incidence of in-hospital events was 14.3% in tertile 1, 17.6% in tertile 2, 23.5% in tertile 3, and 30.8% in tertile 4. The odds ratio of major adverse cardiovascular events was 1.286 [0.397–4.161] in tertile 2, 1.846 [0.492–6.927] in tertile 3, and 2.667 [0.693–10.254] in tertile 4. The cumulative proportion of adverse events was seen higher in tertile 4 on Kaplan-Meier log-rank (chi-square: 8.094, p = 0.044). ConclusionPoor glycemic control or stress hyperglycemia on admission experienced the highest rates of major adverse cardiovascular events including deaths. Plasma random glucose was predictive of a worse prognosis for STEMI patients undergoing PCI in our study.

Evaluating type and amount of dietary protein in relation to metabolic syndrome among Iranian adults: cross-sectional analysis of Fasa Persian cohort study

Background and aimMetabolic syndrome is characterized by several conditions including abdominal obesity, dyslipidemia, impaired glucose levels, and hypertension; which all are directly associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus. This study aimed to evaluate the association of the amount and source of dietary protein with the risk of metabolic syndrome and its components in adult men and women.Material and methodThis study was performed using Persian cohort data, Fasa branch, which included 3660 men and 5262 women. Individuals were divided into five groups for total dietary proteins, plant proteins, and animal proteins using the quintiles, and the odds of incidence for metabolic syndrome and each component was evaluated.ResultsA higher intake of total protein was associated with lower odds of having metabolic syndrome (OR: 0.24 95% CI 0.18–0.33, P-trend < 0.001 in men, OR: 0.42 95% CI 0.34–0.51, P-trend < 0.001 in women) and all of its components. men (OR: 0.35 95% CI 0.25–0.48, P-trend < 0.001) and women (OR: 0.41 95% CI 0.33–0.52, P-trend < 0.001) in the highest quintile of plant protein intake had a reduced prevalence of metabolic syndrome and its components. An increased animal protein intake was associated with a lower prevalence of metabolic syndrome (P-trend < 0.001), a declined risk of having elevated triglycerides (P-trend = 0.016) in men, and a reduced risk of having abdominal obesity in men (P-trend < 0.001) and women (P-trend < 0.001).ConclusionA higher consumption of total protein and plant protein was associated with a lower prevalence of metabolic syndrome and its components. Increased consumption of animal protein seemed to be related to a lower prevalence abdominal obesity. Also, only in men, animal protein was associated with decreased risk of having metabolic syndrome.

Incidence and Attributing Factors of Impaired Blood Glucose in Non-Diabetic Patients on Steroid Therapy

Objective: To determine the incidence and attributing factors of impaired blood glucose in non-diabetic patients on steroid therapy. Methodology: This descriptive study was conducted at the Department of Medicine, Sheikh Zayed Hospital Lahore during 6 months from April 2019 to September 2019. Patients of both genders with age of 18-70 years and receiving steroid therapy (at least 1 pulse) were included. After taking ethical approval, 371 patients were counseled and explained the details of the study. A bolus of 1 gram Methylprednisolone was given and blood was drawn after 2 hours and blood glucose levels were measured. All the labs were acquired from same lab (Hospital lab) and glucometer to eliminate bias and confounding variables were controlled by exclusion. Data was collected via study proforma. Results: The average age of the patients was 43.75 ± 14.33 years with a range of 18 to 70 years. There were 42% males and 57%.1 females with a male to female ratio of 1:1.3. Average BMI of patients 27.34±3.72kg/m2. Impaired blood glucose was observed in 55% of patients after steroid pulse therapy. Frequency of impaired blood glucose after steroid pulse therapy was statistically insignificant according to age and BMI (p-&gt;0.05). Positive family history was significantly higher in a patient with impaired blood glucose after pulse therapy (p-0.001). Conclusion: Impaired blood glucose level was observed to be highly prevalent among non-diabetic patients receiving steroid pulse therapy. Female gender and positive family history of diabetes observed as attributing factors.

Colonic inflammation induces changes in glucose levels through modulation of incretin system

BackgroundThe role of the incretin hormone, glucagon-like peptide (GLP-1), in Crohn’s disease (CD), is still poorly understood. The aim of this study was to investigate whether colitis is associated with changes in blood glucose levels and the possible involvement of the incretin system as an underlaying factor.MethodsWe used a murine model of colitis induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS). Macroscopic and microscopic score and expression of inflammatory cytokines were measured. The effect of colitis on glucose level was studied by measurement of fasting glucose and GLP-1, dipeptidyl peptidase IV (DPP IV) levels, prohormone convertase 1/3 (PC 1/3) and GLP-1 receptor (GLP-1R) expression in mice. We also measured the level of GLP-1, DPP IV and expression of glucagon (GCG) and PC 1/3 mRNA in serum and colon samples from healthy controls and CD patients.ResultsFasting glucose levels were increased in animals with colitis compared to controls. GLP-1 was decreased in both serum and colon of mice with colitis in comparison to the control group. DPP IV levels were significantly increased in serum, but not in the colon of mice with colitis as compared to healthy animals. Furthermore, PC 1/3 and GLP-1R expression levels were increased in mice with colitis as compared to controls. In humans, no differences were observed in fasting glucose level between healthy subjects and CD patients. GLP-1 levels were significantly decreased in the serum. Interestingly, GLP-1 level was significantly increased in colon samples of CD patients compared to healthy subjects. No significant differences in DPP IV levels in serum and colon samples were observed between groups.ConclusionsChanges in the incretin system during colitis seem to contribute to the impaired glucose levels. Differences in incretin levels seem to be modulated by degrading enzyme DPP-IV and PC 1/3. Obtained results suggest that the incretin system may become a novel therapeutic approach in the treatment of CD.

Diabetes and Heart Failure: Multi-Omics Approaches.

Diabetes and heart failure, as important global issues, cause substantial expenses to countries and medical systems because of the morbidity and mortality rates. Most people with diabetes suffer from type 2 diabetes, which has an amplifying effect on the prevalence and severity of many health problems such as stroke, neuropathy, retinopathy, kidney injuries, and cardiovascular disease. Type 2 diabetes is one of the cornerstones of heart failure, another health epidemic, with 44% prevalence. Therefore, finding and targeting specific molecular and cellular pathways involved in the pathophysiology of each disease, either in diagnosis or treatment, will be beneficial. For diabetic cardiomyopathy, there are several mechanisms through which clinical heart failure is developed; oxidative stress with mediation of reactive oxygen species (ROS), reduced myocardial perfusion due to endothelial dysfunction, autonomic dysfunction, and metabolic changes, such as impaired glucose levels caused by insulin resistance, are the four main mechanisms. In the field of oxidative stress, advanced glycation end products (AGEs), protein kinase C (PKC), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) are the key mediators that new omics-driven methods can target. Besides, diabetes can affect myocardial function by impairing calcium (Ca) homeostasis, the mechanism in which reduced protein phosphatase 1 (PP1), sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2a (SERCA2a), and phosphorylated SERCA2a expressions are the main effectors. This article reviewed the recent omics-driven discoveries in the diagnosis and treatment of type 2 diabetes and heart failure with focus on the common molecular mechanisms.

THE RELATIONSHIP BETWEEN DIFFERENT DIABETIC FACTORS IN IMPAIRED FASTING PLASMA GLUCOSE OBESE ELDERLY

Background: In both developed and developing countries, the relationship between aging an obesity is similar and studies appear to be more important at all ages. Therefore, we focused on patients with impaired fasting blood glucose levels to see the baseline changes in insulin homeostasis. The current study seeks to explain the relationship between insulin secretion, insulin resistance, and glucose effects in obese elderly people. Methods: We randomly enrolled 31subjects who were aged 65 years old. All these patients were obese (body mass index ≥ 25 2 kg/m ) and the fasting plasma glucose (FPG) was between 100 and 125 mg/dl. Four diabetic factors were calculated and included rst phase insulin secretion (PFIS), second phase insulin secretion (SFIS), insulin resistance (IR) and glucose effectiveness (GE). Results: In the current study, we enrolled 18 male and 13 female subjects. The mean FPG was 108 (mg/dl) in both male and female. All the demographic data were non-signicant when compared with male and female except the hemoglobin. When we compared these four diabetic factors with FPG, we found only SPIS was signicantly negative correlated with FPG in both genders. Discussion: FPG was correlated with SPIS only. FPIS, IR and GE were not correlated with FPG in impaired fasting plasma glucose obese elderly. Further study is needed for understating the underlying mechanisms.

PM2.5 promotes β cell damage by increasing inflammatory factors in mice with streptozotocin.

Emerging evidence indicates that exposure to fine particulate matter contributes to the onset of diabetes. The present study aimed to investigate the mechanism of particulate matters (PM)2.5 affecting glucose homeostasis in mice with type 1 diabetes mellitus. Male C57BL/6 mice were housed under filtered air (FA) or PM2.5 for 12 weeks and then received intraperitoneal injection of streptozotocin (STZ; 40 mg/kg) or acetic buffer daily for 5 days. At 4 weeks after the last injection, fasting glucose was tested. In the plasma and liver, cholesterol levels were determined by cholesterol oxidase-peroxidase and triglyceride levels were determined by triglycerophosphate oxidase-peroxidase. Homeostasis model assessment of β cell function (Homa-β) was computed based on fasting insulin and glucose levels. Interleukin-1β (IL-1β) and tumor necrosis factor-α (TNFα) levels in plasma, visceral adipose tissues, RAW264.7 macrophages and MIN6 pancreatic β cells treated with PM2.5 (0-50 µg/ml) were quantified via ELISA. Before STZ injection, fasting blood glucose (FBG) levels were similar between FA and PM2.5 groups. After STZ injection, FBG levels were higher in mice pre-exposed to PM2.5 compared with those pre-exposed to FA. When taking FBG levels ≥7 mmol/l as the criteria for impaired glucose level, its incidence was 53.3% and 77.8% in FA and PM2.5 groups, respectively. Independent of STZ injection, IL-1β levels in the adipose tissue were upregulated in mice pre-exposed to PM2.5 compared with FA. The addition of PM2.5 stimulated IL-1β and TNFα production in macrophages and pancreatic β cells, and inhibited the secretion of insulin from MIN6 cells in a dose-dependent manner. In conclusion, pre-exposure of PM2.5 impaired pancreatic β cells in mice upon STZ injection, partially via enhanced inflammation, and suppressed the secretion of insulin.