Impaired Glucose Regulation Group Research Articles

The Effects of Tangning Ziyabitusi on Gut Microbiota and T lymphocyte Subsets in Impaired Glucose Regulation Rats.

Impaired glucose regulation (IGR) represents the prediabetic state and is associated with gut microbiota (GM) dysbiosis and chronic inflammation. Tangning Ziyabitusi Tablet (TZT) is a Chinese Uyghur herbal medicine with preventative and therapeutic effects on diabetes, but its hypoglycemic mechanisms are unclear. Thirty-six male Wistar rats were divided into the normal diet (ND) and IGR groups. The IGR group was given a high-fat diet (HFD). After the IGR model establishment, the ND group was divided into ND and ND+TZT groups, and the IGR group into IGR and IGR+TZT groups. After 8 weeks of TZT administration, 16S rRNA sequencing and untargeted metabolomics were performed on fecal samples. Mesenteric lymph nodes were also collected, and T lymphocytes separated after rats were sacrificed. Flow cytometry was used to characterize different CD4+ T cell subsets in mesenteric lymph nodes. Finally, we analyzed the correlation between GM and characteristic fecal metabolites. Impaired glucose tolerance and insulin resistance were improved in the IGR+TZT group when compared with the IGR group. Bacterial 16S rRNA sequencing results showed that Sobs and Chao1 indices in the IGR group were significantly decreased, but were increased in the IGR+TZT group. The relative abundance of Bacteroidetes was decreased while the relative abundance of Firmicutes was increased in the IGR group. Adlercreutzia abundance was decreased after TZT administration, while the abundance of Christensenellaceae_R-7_group, norank_f_norank_o_Clostridia_UCG-014, UCG-005, and Eubacterium_nodatum_group was increased in the IGR+TZT group. Lymph node CD4+ T cell proportions in the IGR group were significantly increased, while they were significantly decreased in the IGR+TZT group. Correlation analysis showed that tumor necrosis factor-α, interleukin-6, T helper cells (Th1, Th2, Treg), and insulin had a greater impact on GM community structure. TZT improved glucose tolerance and ameliorated GM dysbiosis in IGR rats. Additionally, TZT significantly modulated CD4+ T cell subset proportions in rat mesenteric lymph nodes and fecal metabolism. Moreover, correlation analysis showed that key microbiota was closely related to IGR indices. Thus, TZT modulated GM composition and immune functions of the intestinal mucosa. We provide useful information for the investigation of active mechanisms and the clinical application of TZT.

Elevated triglyceride-glucose (TyG) indexpredicts impaired islet β-cell function: A hospital-based cross-sectional study.

ObjectiveTo explore the relationship between the TyG index and the insulin secretion function of pancreatic β-cells, and to determine the possibility of the TyG index in predicting β-cell dysfunction and the development of diabetes.MethodsA cross-sectional study was performed among 914 participants who took their annual health checkups at the Third Xiangya Hospital. The early- and late-phase pancreatic β-cell secretion was assessed based on the results of the oral glucose tolerance test (OGTT). In addition to anthropometric parameters and laboratory parameters, information about health-related habits and disease histories was obtained from the National Physical Examination Questionnaire. Partial correlation analysis was used to study the relationship between the TyG index and pancreatic β-cell function. The receiver operating characteristic (ROC) curve was used to calculate the cut-off points of the TyG index in predicting β-cell dysfunction. According to the OGTT results and medical history, the participants were categorized into three groups: the normal glucose tolerance group (NGT, n=276), the impaired glucose regulation group (IGT, n=323), and the diabetes group (DM, n=315). The correlation between the TyG index and β-cell function among the three groups and the association between the TyG index and glucose metabolic conditions were further explored.ResultsThe TyG index was negatively correlated with the indexes that reflect the early and late secretory function of β-cells, not only in the NGT group but also in the IGT and DM group. The minimum cut-off values for the TyG index to identify the risk of early- and late-phase β-cell dysfunction are 9.08 and 9.2 respectively. The TyG indexes of the IGT and DM group were higher than that of the NGT group, and with the growth of the TyG index, the risk of prediabetes and diabetes increased significantly.ConclusionIncreased TyG index is associated with impaired β-cell function regardless of the glucose metabolic conditions. The TyG index is an alternative indicator for predicting β-cell dysfunction.

Cardiorespiratory fitness in a population with different glucose metabolic statuses: low cardiorespiratory fitness increases the risk of early abnormal glucose metabolism.

Low cardiorespiratory fitness (CRF) is a risk factor for many chronic diseases. This study aimed to evaluate the CRF of a sample of adults with different glucose tolerance statuses to explore its relationship with early abnormal glucose metabolism according to sex. A total of 93 participants were assigned to three groups, i.e. the normal glucose tolerance (NGT) group, impaired glucose regulation (IGR) group and new-onset type 2 diabetes mellitus (T2DM) group, through an oral glucose tolerance test. Cardiopulmonary exercise testing was performed to evaluate the participants' CRF. The physical measurements (including height, weight, systolic blood pressure [SBP] and diastolic blood pressure) and laboratory test results (including fasting plasma glucose and two-hour plasma glucose [2h-PG]) of all participants were collected. Partial correlation, multiple linear regression (stepwise method) and logistic regression were used to analyse the data. Compared to the males with NGT, those with T2DM or IGR had a lower exercise time (P = 0.044), anaerobic threshold (AT) oxygen uptake (VO2) (P = 0.009), maximum VO2/kg (P = 0.041) and oxygen uptake efficiency slope (P = 0.002). The male participants with T2DM had lower AT power (P = 0.001) than those with IGR or NGT. Compared to the females with NGT, the AT heart rate (HR) (P = 0.003), AT SBP (P = 0.002) and maximum VO2/kg (P = 0.039) were lower in the female T2DM and IGR groups. The multiple linear regression (stepwise method) analyses showed that the maximum VO2/kg (β = -0.268, p = 0.026) and one-minute HR recovery (β = -0.239, p = 0.039) of the females improved the prediction of the 2h-PG when entered in the model. The logistic analysis results indicated that the VO2 max of the male participants was related to pre-diabetes (β = -0.003, p = 0.024) and that their AT power was associated with new-onset diabetes (β = -0.053, p = 0.010). Meanwhile, the AT SBP of the female participants was related to pre-diabetes (β = 0.120, p = 0.019), and their AT HR was related to new-onset diabetes (β = -0.102, p = 0.014). Low CRF is associated with abnormal glucose metabolism. The CRF is closely associated with the 2h-PG after glucose load and is an important risk factor for pre-diabetes and new-onset diabetes.

Impaired glucose tolerance is associated with enhanced postprandial pancreatic polypeptide secretion

BackgroundThe purpose of this study is to compare serum pancreatic polypeptide (PP), insulin, C‐peptide, and glucagon in different glucose tolerance stages; analyze the influencing factors of PP secretion; and further explore the role of PP in the pathogenesis of diabetes mellitus.MethodsData were collected from 100 subjects from hospital. According to the results of oral glucose tolerance test (OGTT), the subjects were divided into a normal glucose tolerance (NGT) group, an impaired glucose regulation (IGR) group, and a newly diagnosed type 2 diabetes mellitus (T2DM) group. PP and the related parameters were measured, and the area under the curve (AUC) 120 min after OGTT was calculated. AUCpp (AUC of PP) was used as the dependent variable and the potentially influencing factors were used as the independent variable for multiple linear regression analysis.ResultsPostprandial 60 min PP in the IGR group was higher than those in the NGT group (2973.80 [±547.49] pg·h/mL vs 2663.55 [±594.89] pg·h/mL, p < 0.05). AUCpp was significantly higher in the IGR group (428.76 pg·h/mL, 95% confidence interval [CI] [41.06 –816.46], p = 0.031) and newly diagnosed T2DM group (404.35 pg·h/mL, 95% CI [5.37–803.33], p = 0.047) than in the NGT group. AUCpp was negatively correlated with body mass index (BMI) (r = −0.235, p = 0.038) and positively correlated with postprandial 60 min blood glucose (r = 0.370, p = 0.001) and AUCbg (AUC of blood glucose) (r = 0.323, p = 0.007). Multiple linear regression analysis indicated that there was a linear correlation between BMI, AUCbg, and AUCpp (p = 0.004, p = 0.001), and the regression equation was calculated as: AUCpp = 6592.272 + 86.275 × AUCbg‐95.291 × BMI (R2 = 12.7%, p < 0.05).ConclusionsCompared with NGT subjects, IGR and T2DM patients have an enhanced postprandial PP secretion. In T2DMs, the secretion of PP is mainly affected by BMI and blood glucose.

Epidemiology and risk factors for diabetes in the suburbs of Beijing: a retrospective cohort study

ObjectiveWe aimed to detect the incidence and risk factors of type 2 diabetes mellitus (T2DM) development in the suburbs of Beijing.DesignCohort study with record linkage to incidence data.SettingWe performed a...

Increasing Imbalance of Treg/Th17 Indicates More Severe Glucose Metabolism Dysfunction in Overweight/obese Patients

Chronic low-grade inflammation and dysfunction of metabolism has been reported to be involved in obesity. Regulatory T cell (Treg) and helper T cell 17 (Th17) are involved in chronic inflammatory diseases. Impaired balance of Treg/Th17 is one of the major factors contributing to inflammatory status in obesity. Overweight/obese patients (n=80) were recruited and classified into three subgroups: normal glucose tolerance group (NGT, n=32), impaired glucose regulation group (IGR, n=19) and type two diabetes mellitus group (T2DM, n=29). Healthy individuals were paired as normal control group (NC, n=37). We used flow cytometry to test the frequencies of circulating Treg and Th17cells of all subjects. Serum IL-6, IL-10, TNF-α, IL-17A levels were detected by cytometric bead array and clinical information was extracted from medical records. In group IGR and T2DM, we revealed a severe decrease in peripheral ratio of Treg/Th17 compared with NC, but no significant difference was seen in group NGT. The serum level of IL-6 in group NGT and T2DM was higher than healthy subjects. The FPG and HbA1c levels were negatively correlated with the ratio of Treg/Th17 in overweight/obese patients. ROC curve analysis revealed that peripheral Treg/Th17 ratio <1.255 was a risk factor for prediabetes and diabetes in overweight/obese patients. Peripheral Treg/Th17 imbalance exists in overweight/obese patients with IGR or T2DM and peripheral Treg/Th17 imbalance might be a risk factor for prediabetes and diabetes in overweight/obese patients.

Correlation of type 2 diabetes and impaired glucose regulation with chronic kidney disease in middle-aged and elderly individuals

To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou. Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR. Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups (P < 0.05). In IGR group, age, hypertension, and hypertriglyceridemia were positively correlated with the risk of RI (OR: 1.113, 1.904, and 2.608, respectively; P < 0.05). In diabetes group, age, coronary heart disease, obesity, hypertriglyceridemia, and elevated LDL-C level were positively correlated with the risk of RI (OR: 1.069, 2.535, 3.359, 1.827, and 2.690, respectively; P < 0.05). Logistic regression analysis showed that diabetes mellitus significantly increased the risk of albuminuria (OR: 1.543, P=0.000) and RI (OR: 1.446, P=0.005). Logistic regression analysis and multivariate regression analysis showed that although the deterioration trends of eGFR were similar in diabetes group and IGR group, IGR was not a significant risk factor for albuminuria or RI (OR:1.057, P=0.355; OR: 0.918, P=0.614). Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.

DS21, a new noninvasive technology, is effective and safe for screening for prediabetes and diabetes in Chinese population

BackgroundScreening for prediabetes and asymptomatic diabetes is important for preventing development to an irreversible stage. The current diagnosis of prediabetes and diabetes is based on blood glucose or HbA1c (an invasive method). The aim of this study was to assess the efficacy and safety of DS21, a new noninvasive technology, for noninvasive screening for prediabetes and diabetes.MethodsA total of 939 subjects were divided into a normal control group (NC, n = 308), impaired glucose regulation group (IGR, n = 312), and diabetes (DM) group (n = 319). All subjects underwent the DS21 test, and mean hands–feet, hand, and feet conductance values were analyzed. The diagnostic accuracy of the conductance value was analyzed by receiver-operating characteristic (ROC) curve.ResultsThe conductance values for hands–feet, hands, and feet in the DM and IGR groups were significantly lower than those in the NC group (all P < 0.01). The area under the ROC curve (AUCROC) for distinguishing NC/IGR was highest when using hands–feet conductance values (0.766 [95% confidence interval, CI 0.730, 0.803]). However, the AUCROCs of distinguishing NC/abnormal glucose metabolism (AGM, including IGR+DM), non-diabetes (NDM)/DM, and IGR/DM were highest when using conductance values for hands at 0.782 [95% CI 0.752, 0.812], 0.688 [95% CI 0.653, 0.723] and 0.573 [95% CI 0.528, 0.617], respectively (all P < 0.01). Hand conductance of values 75.0 (sensitivity 0.769, specificity 0.660), 77.1 (sensitivity 0.718, specificity 0.695), 68.4 (sensitivity 0.726, specificity 0.555), and 58.1 (sensitivity 0.384, specificity 0.744) were recommended as the screening thresholds for NC/AGM, NC/IGR, NDM/DM, and IGR/DM, respectively. A hand conductance value 66.0 was also recommended to distinguish NC/AGM due to its high sensitivity and high PPV. No adverse events occurred in the test.ConclusionsDS21 is fast, noninvasive, low cost, reliable and safe, which makes it a feasible device for screening for prediabetes and diabetes, especially in a large population.

2267-PUB: 1,5-Anhydroglucitol X Glycated Hemoglobin A1c/100: A Potential Biomarker for Islet ß-Cell Function in Type 2 Diabetes Mellitus

Aims: The goals of the current study were to explore the level of and changes in the AH index (AHI, defined as 1,5-anhydroglucitol × glycated hemoglobin A1c/100) associated with different glucose metabolism statuses, and to evaluate the islet function and insulin sensitivity of type 2 diabetes mellitus (T2DM) patients with different AHI levels. Methods: A total of 3562 individuals were enrolled in the study. According to the 2010 American Diabetes Association (ADA) diagnostic criteria, 1697 subjects were diagnosed as T2DM. The disposition index (DI) was defined as the product of insulin sensitivity-related indexes and islet secretion function. Results: The overall AHI level was 1.0 (0.7-1.3), while the AHI level of the T2DM group was 0.8 (0.5-1.2), which was significantly lower than that of the normal glucose tolerance group and the impaired glucose regulation group [both AHI 1.2 (0.9-1.5), and P &amp;lt; 0.01]. The T2DM group was further divided into four subgroups according to the quartile of AHI level. The results demonstrated that the homeostasis model assessment of insulin resistance (HOMA-IR) decreased with the increase of AHI level (P for trend &amp;lt; 0.01). However, other parameters [i.e., HOMA of β-cell function (HOMA-β), insulin generation index, insulin sensitivity index, and DI] increased while AHI level increased (all P for trend &amp;lt; 0.01). Multivariate logistic regression illustrated that the odds ratios for a low DI for increasing levels of AHI were 1.00, 0.22 (0.16-0.29), 0.16 (0.11-0.22), and 0.09 (0.06-0.13), respectively, showing a decreasing trend (P for trend &amp;lt; 0.01). Conclusion: AHI could reflect the changes in the trend of glucose metabolism disorder and the function of islet β cells to some extent. The lower AHI was associated with worsening of the glucose metabolism disorder in recent years, and the islet β-cell function was correspondingly poor. Disclosure X. Ma: None. H. Su: None. Y. Shen: None. X. He: None. L. Ying: None. W. Zhu: None. Y. Wang: None. Y. Bao: None. J. Zhou: None.

Correlation Between Circulating Levels of Secreted Frizzled-Related Protein 5 and Type 2 Diabetic Patients and Subjects with Impaired-Glucose Regulation.

BackgroundSecreted frizzled-related protein 5 (SFRP5) is a recently identified adipokine; however, its functions during pathogenesis of T2DM and obesity remain unclear. This research attempted to investigate associations between circulating SFRP5 and obesity/T2DM.Materials and MethodsAccording to diagnosis, 107 patients were assigned as impaired-glucose regulation (IGR) and 111 patients newly-diagnosed as T2DM were assigned as the T2DM group. Meanwhile, 132 subjects with normal-glucose tolerance (NGT) were assigned as the NGT group. Differences in plasma SFRP5 levels among three groups were compared. Correlation between SFRP5 levels and different metabolic markers was analyzed. Multiple-linear stepwise regression analyses were performed to determine independent factors for SFRP5. Patients in the T2DM group were administrated with metformin for 12 weeks. Meanwhile, changes in plasma SFRP5 levels were also analyzed.ResultsPlasma SFRP5 level of the IGR group was significantly lower compared to the NGT group (219.1±39.7 pg/mL vs 236.7±72.6 pg/mL, P<0.05), however, that of the T2DM group was significantly lower compared to the IGR group (203.5±42.1 pg/mL vs 219.1±39.7 pg/mL, P<0.01). Level of plasma SFRP5 was negatively correlated with fasting plasma glucose, BMI, waist circumference (WC), normalized WC (waist-to-height ratio) (WHtR), 2h plasma glucose, fasting insulin, glycosylated hemoglobin (HbA1c), fasting C-peptide, HOMA-IR, and hs-CRP (P<0.01). Among the above factors, HbA1c and fasting insulin levels (FIns) were two independent factors. Plasma SFRP5 levels were increased after 12-week metformin treatment (201.0±34.8 pg/mL vs 213.1±34.4 pg/mL, P<0.05), while insulin resistance was alleviated (ln(HOMA-IR): 1.35±0.55 vs 1.07±0.49, P<0.01).ConclusionMetformin reduced circulating levels of secreted frizzled-related protein 5 and improved pathophysiological parameters of T2DM.

Metagenomics and Faecal Metabolomics Integrative Analysis towards the Impaired Glucose Regulation and Type 2 Diabetes in Uyghur-Related Omics.

Objective Gut microbiota and their metabolites play an important role in the development of type 2 diabetes mellitus (T2DM). This research was designed to study the relationship between gut microbiota and faecal metabolites of Uyghur newly onset T2DM and impaired glucose regulation (IGR) patients. Materials and Methods A total of 60 different glycemic Uyghur subjects were enrolled and divided into T2DM, IGR, and normal glucose tolerance (NGT) groups. Metagenomics and LC-MS-based untargeted faecal metabolomics were employed. Correlations between bacterial composition and faecal metabolomics were evaluated. Results We discovered that the composition and diversity of gut microbiota in newly onset T2DM and IGR were different from those in NGT. The α-diversity was higher in NGT than in T2DM and IGR; β-diversity analysis revealed apparent differences in the bacterial community structures between patients with T2DM, IGR, and NGT. LC-MS faecal metabolomics analysis discovered different metabolomics features in the three groups. Alchornoic acid, PE (14 : 0/20 : 3), PI, L-tyrosine, LysoPC (15 : 0), protorifamycin I, pimelic acid, epothilone A, 7-dehydro-desmosterol, L-lysine, LysoPC (14 : 1), and teasterone are the most significant differential enriched metabolites. Most of the differential enriched metabolites were involved in metabolic processes, including carbohydrate metabolism, starch and sucrose metabolism, phenylpropanoid biosynthesis, and biosynthesis of amino acids. Procrustes analysis and correlation analysis identified correlations between gut microbiota and faecal metabolites. Matricin was positively correlated with Bacteroides and negatively correlated with Actinobacteria; protorifamycin I was negatively correlated with Actinobacteria; epothilone A was negatively correlated with Actinobacteria and positively correlated with Firmicutes; PA was positively correlated with Bacteroides and negatively correlated with Firmicutes; and cristacarpin was positively correlated with Actinobacteria; however, this correlation relationship does not imply causality. Conclusions This study used joint metagenomics and metabolomics analyses to elucidate the relationship between gut microbiota and faecal metabolites in different glycemic groups, and the result suggested that metabolic disorders and gut microbiota dysbiosis occurred in Uyghur T2DM and IGR. The results provide a theoretical basis for studying the pathological mechanism for further research.

Association of insulin, C-peptide and blood lipid patterns in patients with impaired glucose regulation

BackgroundTo investigate any associations between blood glucose (BG) and lipid levels in patients with different glucose tolerance statuses, including type 2 diabetes (T2DM) and impaired glucose regulation (IGR) cases as well as normal glucose tolerance (NGT) individuals.MethodsA total of 354 participants were recruited to this study including 174 in the T2DM group, 112 in the IGR group and 68 in the NGT group. We compared BG, insulin and C-peptide (CP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) serum levels during a 3 h oral glucose tolerance test (OGTT) in the 3 groups.ResultsBasic overall HbA1c serum concentration percentages were 5.52, 6.33 and 9.76% for the NTG, IGR and T2DM cases. During the OGTT, insulin secretion in the IGR group was almost double that of the T2DM group. CP levels were highest in the IGR patients and OGTT related BG concentrations were highest in the T2DM group followed by IGR, but in the IGR group hyperglycemia was less pronounced than in T2DM patients (P < 0.001). Compared to the NGT group, TC, TG and LDL-C serum concentrations were significantly higher (P ≤ 0.001) and HDL-C concentrations were significantly lower (P ≤ 0.001) in IGR and T2DM cases compared to the NTG group.ConclusionsIGR led to similar unfavorable blood lipid patterns compared with T2DM patients and an imbalance of insulin and CP serum concentrations during an OGTT.

Contribution of epicardial and abdominopelvic visceral adipose tissues in Chinese adults with impaired glucose regulation and diabetes.

To quantify epicardial adipose tissue (EAT) and visceral adipose tissue (VAT) in Chinese adults with impaired glucose regulation (IGR) or diabetes and compare the contributions of EAT and VAT to the occurrence of IGR and diabetes with those of traditional obesity indices. Cardiac and abdominopelvic noncontrast computed tomographic images of 668 individuals were used to measure EAT and VAT volume. Multivariable logistic regression and area under the receiver operating characteristic (ROC) curve were used to illustrate the contributions of these tissues. Patients with IGR or diabetes had larger EAT and VAT volumes than did the controls, and the VAT volume was significantly different between the IGR and diabetic groups. In multivariable models, higher EAT or VAT volume was positively associated with the presence of IGR and diabetes. After adjusting further for body mass index (BMI) and waist-to-hip ratio (WHR), a higher EAT volume was still positively associated with IGR (odds ratio (OR) = 1.46; 95% confidence interval (CI), 1.04-2.03), and a higher VAT volume was positively associated with IGR (OR = 1.86; 95% CI, 1.15-3.02) and diabetes (OR = 1.86; 95% CI, 1.16-2.99). The areas under the curve (AUCs) of the association of EAT (AUC = 0.751; 95% CI, 0.712-0.789) and VAT (AUC = 0.752; 95% CI, 0.713-0.792) with dysglycemia (IGR + diabetes) were significantly larger than those of the traditional obesity indices (all P < 0.05). High EAT or VAT volume is positively associated with IGR and diabetes in Chinese adults. With a given WHR and BMI, such an association still exists to some extent. The correlation may be stronger than those of the traditional obesity indices.

Circulating Vascular Cell Adhesion Molecule-1 (VCAM-1) and Intercellular Adhesion Molecule-1 (ICAM-1): Relationship with carotid artery elasticity in patients with impaired glucose regulation (IGR)

ObjectiveTo investigate the relations of circulating adhesion molecule vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) with carotid artery elasticity in patients with impaired glucose regulation (IGR). MethodsA total of 208 subjects were enrolled from January 2013 to March 2014. One hundred forty-eight were IGR patients, and 60 had normal glucose tolerance (NGT). Carotid intima-media thickness (IMT), carotid artery pressure-strain elasticity coefficient (Eρ), stiffness (β), arterial compliance (AC), and pulse wave velocity (PWVβ), as well as blood pressure, body mass index, blood glucose, blood lipids, insulin resistance index, VCAM-1, and ICAM-1 were measured and compared between IGR and NGT patients. ResultsEρ, β and PWVβ were significantly higher in the IGR group than in the NGT group (P<0.05), but the IMT showed no significant difference (P>0.05). VCAM-1 and ICAM-1 were significantly higher in the IGR group than in the NGT group (P<0.05). VCAM-1 and ICAM-1 were positively correlated with Eρ, β, and PWVβ and negatively correlated with AC in IGR patients. ConclusionsChanges in carotid artery elasticity and endothelial dysfunction are found in patients with IGR. Early comprehensive intervention should be performed in such IGR populations.

Impact of impaired glucose regulation on the functions of large and small fibers of peripheral nerves

This article analyzes the incidence and characteristics of peripheral neuropathy in patients with impaired glucose regulation (IGR). A total of 120 IGR patients and 60 healthy controls were enrolled. All subjects underwent nerve conduction study (NCS) of large fibers and skin sympathetic response (SSR) and contact heat pain evoked potential (CHEP) testing of small fibers with a Medtronic Keypoint machine (Medoc Ltd., Israel). IGR patients were evaluated using the Michigan Neuropathy Screening Instrument (MNSI). The abnormal rates (MNSI >2) in IGR patients and NCS and SSR evaluations were 18.3%, 22.5%, and 39.2%, respectively. All abnormal NCS findings were accompanied with abnormal SSR findings. Compared with the control group, the sensory nerve action potential wave of the posterior tibial and sural nerve was decreased in the IGR group (P = 0.01, P = 0.00), the SSR wave was reduced in the upper and lower limbs (P = 0.002, P = 0.00), and the CHEP wave was decreased in opisthenar and shank (P = 0.00). Compared with the control group, the CHEP wave was decreased in the shank in the normal SSR group (P < 0.05) and in the opisthenar and shank in the normal NCS group (P < 0.05). IGR patients have peripheral neuropathy characterized by impaired functions of large and small fibers focused on small fiber and lower limb sensory nerves. CHEP can detect small fiber damage earlier than SSR and NCS.

A non-targeted metabolomics study on different glucose tolerance states

A non-targeted metabolomics method was employed to study metabolic characteristics in subjects with different glucose tolerance. Plasma samples of 120 participants with normal glucose tolerance (NGT), impaired glucose regulation (IGR), and type 2 diabetes (T2D) were collected. Gas chromatography/mass spectrometry (GC/MS) was used to profile and compare the plasma metabolome among the three groups. Through the use of multivariate statistical analysis, we found distinct metabolome change from NGT to IGR and to T2D. ANOVA found that the IGR and T2D groups had perturbations of monosaccharide and lipid metabolism, disorders of glucogenic amino acids, and branched-chain amino acid catabolism. Furthermore, we also found that the levels of 2-hydroxybutyrate and 2-ketoisocaproate were progressively increased with glucose tolerance severity. The results from this study help us better understand the relationship between plasma metabolism and glucose tolerance states and also suggest that 2-hydroxybutyrate and 2-ketoisocaproate may be closely associated with the development of T2D.

Islet β-cell function in patients with gout and hyperuricemia accompanied by increased 1h postload plasma glucose

All of 143 patients with gout or hyperuricemia were divided into type 2 diabetes(n=43), impaired glucose regulation(n=45), and normal glucose tolerance(n=55)groups. Moreover, a cut point of 8.6 mmol/L in one hour postload plasma glucose(1hPG)of oral glucose tolerance test was used to sub-divide the normal glucose tolerance group into 1hPG≥8.6 mmol/L(n=30)and 1hPG 0.05). The first-phase insulin secretion index revealed no significant difference between impaired glucose regulation and 1hPG≥8.6 mmol/L groups(P>0.05), but obviously decreased in these two groups compared with 1hPG<8.6 mmol/L group(P<0.05). The modified β cell function indexes were gradually decreased in 1hPG<8.6 mmol/L, 1hPG≥8.6 mmol/L, and impaired glucose regulation groups(P<0.05). These results suggest that when 1hPG of the patients with gout and hyperuricemia is over 8.6 mmol/L, the first-phase insulin secretion will be impaired. (Chin J Endocrinol Metab, 2018, 34: 300-303) Key words: Gout; Hyperuricemia; β-cell function

Impact of different glucose metabolism status on clinical outcomes of open arthrolysis for post-traumatic elbow stiffness

Diabetes and prediabetes are worldwide public health problems and are considered predisposing factors for adverse functional outcomes after various orthopedic operations. The purpose of this retrospective study was to determine the impact of glucose metabolism status on functional outcomes and complications after open arthrolysis for post-traumatic elbow stiffness. The study included 152 patients with post-traumatic elbow stiffness undergoing arthrolysis, including 120 in the normoglycemic group, 21 in the impaired glucose regulation group, and 11 in the diabetes mellitus group. General patient data, functional performance, and complications were documented and analyzed. Demographic data and disease characteristics were comparable at baseline. Postoperatively, significant differences were found in range of motion and the Mayo Elbow Performance Score: the diabetes mellitus group had the poorest clinical outcomes. However, there were no significant differences in forearm rotation, visual analog scale pain scores, and complication rates. Patients with post-traumatic elbow stiffness and abnormal glucose metabolism were at increased risk of poorer outcomes after open arthrolysis, and patients with diabetes mellitus had the poorest performance. This study underlines the importance of glycemic control in patients with abnormal glucose metabolism before open arthrolysis.

Plasma Asprosin Concentrations Are Increased in Individuals with Glucose Dysregulation and Correlated with Insulin Resistance and First-Phase Insulin Secretion.

Background Adipokines are reported to participate in many common pathologic processes of glucose dysregulation, such as insulin resistance, β-cell dysfunction, and chronic inflammation. Objective To detect the concentrations of plasma asprosin in subjects with impaired glucose regulation (IGR) and newly diagnosed type 2 diabetes (nT2DM) and its relationship to parameters of glucose and lipid metabolism, insulin resistance, and pancreatic β-cell function. Methods 143 eligible participants were included and were divided into three groups including normal glucose regulation (NGR, n = 52), IGR (n = 40), and nT2DM group (n = 51). The intravenous glucose tolerance test (IVGTT) and clinical and biochemical parameters were measured in all participants. Results Plasma asprosin levels were higher in IGR (82.40 ± 91.06 ng/mL, P < 0.001) and nT2DM (73.25 ± 91.69 ng/mL, P < 0.001) groups compared with those in the NGR (16.22 ± 9.27 ng/mL) group, especially in IGR subjects. Correlation analysis showed that plasma asprosin levels were positively correlated with waist circumference (Wc), fasting plasma glucose (FPG), postchallenge plasma glucose (2hPG), HbA1c, triglyceride (TG), and homeostasis model assessment for insulin resistance (HOMA-IR) and negatively correlated with homeostasis model assessment for β-cell function (HOMA-β), area under the curve of the first-phase (0–10 min) insulin secretion (AUC), acute insulin response (AIR), and glucose disposition index (GDI) (all P < 0.05). Multiple logistical regression analyses revealed that plasma asprosin concentrations were significantly correlated with IGR and nT2DM after controlling for age, sex, BMI, and WHR. Conclusions Circulating asprosin might be a predictor of early diagnosis in DM and might be a potential therapeutic target for prediabetes and T2DM.

Plasma Alkylresorcinol Metabolite, a Biomarker of Whole-Grain Wheat and Rye Intake, and Risk of Type 2 Diabetes and Impaired Glucose Regulation in a Chinese Population.

To examine the association of plasma alkylresorcinol metabolite 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), a biomarker of whole-grain wheat and rye intake, with type 2 diabetes (T2D) and impaired glucose regulation (IGR) in a Chinese population. A total of 1,060 newly diagnosed T2D patients, 736 newly diagnosed IGR patients, and 1,443 control subjects with normal glucose tolerance were recruited in the case-control study. Plasma DHPPA concentrations were determined by high-performance liquid chromatography-tandem mass spectroscopy. Multivariate logistic regression analysis was used to evaluate the independent association of plasma DHPPA concentrations with the likelihood of T2D and IGR. After adjustment for age, sex, BMI, and family history of diabetes, the odds ratios (95% CI) of T2D and IGR were 0.57 (0.45, 0.73) and 0.66 (0.50, 0.85), respectively, comparing the lowest with the highest quartile of plasma DHPPA concentrations. Further adjustment for current smoking status, current alcohol consumption, physical activity, history of hypertension, and educational level did not change the observed association materially. Similar results were also obtained in T2D and IGR groups combined. The inverse association of plasma DHPPA with T2D persisted in stratified analyses according to age, sex, BMI, current smoking status, current alcohol consumption, physical activity, family history of diabetes, and history of hypertension. These findings suggested that higher plasma DHPPA concentrations were associated with lower odds of T2D and IGR. Further studies are warranted to confirm these findings in prospective cohorts.