Impaired Glucose Tolerance Subjects Research Articles

Glucolipid metabolism improvement in impaired glucose tolerance subjects consuming a Quinoa-based diet: a randomized parallel clinical trial.

Purpose: To investigate the effects of quinoa on glucose and lipid metabolism, and the prognosis in people with impaired glucose tolerance. Methods: One hundred and thirty-eight patients diagnosed with impaired glucose tolerance following a glucose tolerance test in Guangzhou Cadre Health Management Center were selected and randomly divided into quinoa intervention and control groups, according to the digital table method. After 1year of follow-up, the differences in blood glucose, blood lipid, glycosylated hemoglobin and other indicators were compared. The disease prognosis between the two groups was also compared. Results: The 2h postprandial blood glucose, glycosylated hemoglobin, insulin resistance index, total cholesterol, low-density lipoprotein cholesterol, body mass index, waist circumference, systolic and diastolic blood pressure after intervention in the quinoa group were significantly lower than before intervention. In contrast, high-density lipoprotein cholesterol was higher than before intervention and is statistically significant (p < 0.05). After 1year of follow-up, the control group's glycosylated hemoglobin and body mass index are higher than before intervention, and are statistically significant (p < 0.05). The 2h postprandial blood glucose, glycosylated hemoglobin, insulin resistance index, body mass index, and mean diastolic blood pressure in the quinoa group are statistically significantly lower than in the control group, while high-density lipoprotein cholesterol is higher (p < 0.05). The rate of conversion to diabetes for participants in the quinoa group (7.8%) is statistically significantly lower than in the control group (20.3%) (χ2 = 12.760, p = 0.002). Logistic regression analysis showed that quinoa consumption is a protective factor against delaying the progression of diabetes (p < 0.05). Conclusion: Adding quinoa to staple food intake can reduce postprandial blood glucose, and improve lipid metabolism and insulin resistance, delaying the progression of diabetes in people with impaired glucose tolerance.

Long-term effects of lowering postprandial glucose level on cardiovascular outcomes in early-stage diabetic patients with coronary artery disease: 10-year post-trial follow-up analysis of the DIANA study

AimsTo elucidate the long-term cardiovascular benefit of lowering postprandial hyperglycemia (PPG) in early-stage T2DM patients. MethodsThis 10-year post-trial follow-up study included 243 patients from the DIANA (DIAbetes and diffuse coronary Narrowing) study, a multi-center randomized controlled trial which compared the efficacy of one-year life-style and pharmacological (voglibose/nateglinide) intervention lowering PPG on coronary atherosclerosis in 302 early-stage T2DM subjects [impaired glucose tolerance (IGT) or newly-diagnosed T2DM] (UMIN-CTRID#0000107). MACE (all-cause death, non-fatal MI or unplanned coronary revascularization) were compared in (1) three assigned therapies (life-style intervention/vogliose/nateglinide) and (2) patients with and without improvement of PPG (reversion from IGT to NGT or from DM to IGT/NGT on 75 g oral glucose tolerance test). ResultsDuring the 10-year post-trial observational period, voglibose (HR = 1.07, 95%CI: 0.69–1.66, p = 0.74) or nateglinide (HR = 0.99, 95%CI: 0.64–1.55, p = 0.99) did not reduce MACE. Similarly, achieving the improvement of PPG was not associated with a reduction of MACE (HR = 0.78, 95%CI: 0.51–1.18, p = 0.25). However, in IGT subjects (n = 143), this glycemic management significantly reduced the occurrence of MACE (HR = 0.44, 95%CI: 0.23–0.86, p = 0.01), especially unplanned coronary revascularization (HR = 0.46, 95%CI: 0.22–0.94, p = 0.03). ConclusionsThe early improvement of PPG significantly reduced MACE and unplanned coronary revascularization in IGT subjects during the post-trial 10-year period.

The Relationship Between Dietary Patterns and Glycemic Variability in People with Impaired Glucose Tolerance

BackgroundDiurnal glucose fluctuations are increased in prediabetes and might be affected by specific dietary patterns. ObjectivesThe present study assessed the relationship between glycemic variability (GV) and dietary regimen in people with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT). MethodsForty-one NGT (mean age: 45.0 ± 9.0 y, mean BMI: 32.0 ± 7.0 kg/m2) and 53 IGT (mean age: 48.4 ± 11.2 y, mean BMI: 31.3 ± 5.9 kg/m2) subjects were enrolled in this cross-sectional study. The FreeStyleLibre Pro sensor was used for 14 d, and several parameters of GV were calculated. The participants were provided with a diet diary to record all meals. ANOVA analysis, Pearson correlation, and stepwise forward regression were performed. ResultsDespite no difference in diet patterns between the 2 groups, GV parameters were higher in IGT than in NGT. GV worsened with an increase in overall daily carbohydrate and refined grain consumption and improved with the increase in whole grain intake in IGT. GV parameters were positively related [r = 0.14–0.53; all P < 0.02 for SD, continuous overall net glycemic action 1 (CONGA1), J-index, lability index (LI), glycemic risk assessment diabetes equation, M-value, and mean absolute glucose (MAG)], and low blood glucose index (LBGI) inversely (r = −0.37, P = 0.006) related to the total percentage of carbohydrate, but not to the distribution of carbohydrate between the main meals in the IGT group. A negative relationship existed between total protein consumption and GV indices (r = −0.27 to −0.52; P < 0.05 for SD, CONGA1, J-index, LI, M-value, and MAG). The total EI was related to GV parameters (r = 0.27–0.32; P < 0.05 for CONGA1, J-index, LI, and M-value; and r = −0.30, P = 0.028 for LBGI). ConclusionsThe primary outcome results showed that insulin sensitivity, calories, and carbohydrate content are predictors of GV in individuals with IGT. Overall, the secondary analyses suggested that carbohydrate and daily consumption of refined grains might be associated with higher GV, whereas whole grains and daily protein intake were related to lower GV in people with IGT.

Serum Triglyceride and Total Cholesterol in Association with IGT: A Case Control Study among Bangladeshi Adults in Jashore City

Background: Existing researches demonstrated that hyperglycemia was associated with elevated serum Triglyceride (TG) and Total Cholesterol (TC). It is imperative to identify prediabetic conditions like Impaired Glucose Tolerance (IGT) for prevention or delay in the development of Type 2 Diabetes Mellitus (T2DM). It is also quite comprehensible that early diagnosis of IGT provides opportunity for effective interventions like dietary and lifestyle modification.The primary objective of this study was to investigative the association of serum TG and TC with IGT in an urban area of Bangladesh. Materials and methods: This study was an observational study with a case-control design carried out on a total of 102 IGT subjects and 150 age, Body Mass Index (BMI) and Waist-Hip Ratio (WHR) matched control subject, over 2 years of time.Biochemical tests including Fasting Plasma Glucose (FPG) plasma glucose2 hours after 75 grams glucose load (2 h PG) serum TC and serum TG using slandered procedure. IBM SPSS Statistics 25 version was used for statistical analysis. Results: Serum TG level was significantly high in IGT cases when compared with controls.Serum TC was also different in cases when compared to controls, but was not significant statistically. Conclusion: Higher level of serum TG is associated with IGT. The association of high serum TC and IGT was not decisive. IAHS Medical Journal Vol 5(1), June 2022; 12-15

Effect of Apple Consumption on Postprandial Blood Glucose Levels in Normal Glucose Tolerance People versus Those with Impaired Glucose Tolerance.

The present study investigated the effect of apple consumption on postprandial blood glucose and insulin levels in subjects with normal versus impaired glucose tolerance. The study participants were ten healthy subjects with no glucose intolerance (normal subjects) (mean, 24.4 ± 4.8 years) and nine subjects with impaired glucose tolerance (mean, 45.2 ± 11.1 years, including 2 on insulin therapy). The test meal included white rice (148 g) and a Fuji apple (150 g). The normal subjects were randomly divided into two groups: the apple-first group, wherein the subjects consumed white rice 5 min after consuming the apple, and the rice-first group, wherein the subjects consumed an apple 5 min after consuming the white rice. Blood samples were then taken from both groups for 3 h. In addition, the subjects with impaired glucose tolerance received the same treatment as the normal subjects, with the difference being glucose level monitoring according to the order in which the apples were consumed. In the normal subjects, the Cmax of Δblood glucose and Δinsulin levels were 54.0 ± 5.0 mg/dL and 61.9 ± 7.2 µU/dL versus 46.2 ± 5.9 mg/dL and 49.8 ± 8.5 µU/dL in the rice-first and apple-first groups, respectively. The incremental area under the curve (iAUC) of insulin tended to decrease in the apple-first group. In the impaired glucose tolerance subjects, the Cmax of Δblood glucose was 75.2 ± 7.2 mg/dL in the apple-first group compared to 90.0 ± 10.0 mg/dL in the rice-first group, which was a significant difference (p < 0.05). The iAUC of blood glucose was lower in the apple-first group. Eating an apple before a meal may be a simple and effective strategy for managing the glycaemic response in individuals with impaired glucose tolerance.

Identifying potential therapeutic targets of Tang-Yi-Ping for the treatment of impaired glucose tolerance: a tandem mass tag-labeled quantitative proteomic analysis.

BackgroundThis study uses the tandem mass tag (TMT)-labeled quantitative proteomic analysis to identify potential therapeutic protein targets of a Chinese prescription called Tang-Yi-Ping (TYP) for the treatment of impaired glucose tolerance (IGT) in rats.MethodsA total of 31 specific-pathogen free (SPF) male Wistar rats were used in our study. Ten were randomly selected as a control group, while 21 received a high-sugar and high-fat diet combined with an intraperitoneal injection of streptozotocin to establish IGT subjects. After eliminating 2 rats without successful modeling, 19 were randomly divided into a TYP group (n=9) and IGT model group (n=10). The TYP group was given a TYP decoction of 6.36 mg/kg−1/d−1. After 8 weeks of intervention, blood glucose-related indicators were measured, and cell morphology was observed by hematoxylin and eosin (HE) staining. TMT-labeled proteomic analysis was applied to detect the differentially expressed proteins (DEPs) in the pancreases of the three groups. The intersection of the DEPs in both the TYP group and IGT model group underwent Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses to identify the related biological functions and signal transduction pathways. Finally, western blot (WB) was used to verify the TMT proteomics results.ResultsTYP can effectively reduce blood glucose and improve islet morphology in IGT rats. We identified a total of 16 potential therapeutic protein targets of TYP, 4 of which were upregulated, while 12 were downregulated, including Rbp4, Fam3b, Flot2, etc. [fold change (FC) >1.1, P<0.05]. The significant signal transduction pathways included arginine and proline metabolism, glyceride metabolism, glycerophospholipid metabolism, mTOR, Wnt, and insulin signaling pathways.ConclusionsFor anti-IGT therapy, we found TYP regulates 16 protein targets, multiple biological functions, and multiple signal transduction pathways. This study thus makes a significant contribution to identifying new potential therapeutic targets for treating IGT.

Dose-Effect of a 6-week treatment with PEP2DIA®, a Patented Milk Protein Hydrolysate on Sucrose Tolerance in Goto-Kakizaki (GK) Rats

Abstract Objectives The study was designed to evaluate the dose-effect of PEP2DIA(r)(PEP), a milk protein hydrolysate on glycemic control of type 2 diabetic Goto-Kakizaki (GK) rats treated for 6 weeks. Methods Rats (n = 10) were treated with PEP solubilized in spring water by oral gavage once a day for 6 weeks. The effects of a 6-week-administration of PEP (63 mg/kg, 88.6 mg/kg and 126 mg/kg per os) were evaluated on sucrose tolerance and insulin response to sucrose in type 2 diabetic GK rats from weaning (3 weeks) to adult age (9 weeks). Circulating GLP-1 concentration and DDP-4 activity, α-glucosidase activity in duodenum and jejunum, Fatty Acid Synthase (FAS) and Sterol regulatory element-binding protein 1 (SREBP-1c) gene expressions in liver and retroperitoneal adipose tissue were also measured. PEP is a patented milk protein hydrolysate containing AP dipeptides which inhibit alpha glucosidase. The alpha-glucosidase inhibitor Acarbose (40 mg/kg) was used as reference. Results The 6 week-treatment with PEP at 3 doses improved sucrose tolerance with the best effect at the dose of 63 mg/kg. Insulin response to sucrose was lower than control after PEP treatment at all the doses tested with the strongest decrease with 63 mg/kg of PEP. This decrease in insulin response seems to be at least in part the consequence of an improvement of the insulin resistance of the GK rats. At the lowest dose tested (63 mg/kg), FAS and SREBP-1c gene expressions were significantly decreased in retroperitoneal adipose tissue of GK rats, suggesting that PEP inhibited lipogenesis. PEP treatment induced strong increases in GLP-1 plasma level at all the doses tested but the difference reached significance only with 63 and 126 mg/kg of PEP. An inhibition of alpha-glucosidase in duodenum but not in jejunum was observed after the 6-week-treatment with PEP. Moreover, in retroperitoneal adipose tissue, PEP at the lowest dose tested (63 mg/kg), significantly decreased gene expression of both SREBP-1c and FAS, suggesting a beneficial effect on triglyceride accumulation in adipose tissue Conclusions These results showed that PEP2DIA(r) could have a beneficial effect on glycemic control of type 2 diabetic GK rats and suggest that this milk protein hydrolysate should be beneficial Impaired Fasting Glucose or Impaired Glucose Tolerance subjects for delaying the progression to overt type 2 diabetes. Funding Sources INGREDIA S.A.

Pro12Ala polymorphism in PPAR-γ gene of impaired glucose tolerance subjects in Bangladeshi population

Pro12Ala polymorphism in PPAR-gamma (PPAR-γ) gene is associated obesity and hyperglycemia in some races, but controversy exists for other races. In this study, 113 impaired glucose tolerance (IGT) and 113 healthy control subjects were recruited. Wild type (CC), heterozygous (CG), and homozygous (GG) variants of Pro16Ala polymorphism of PPAR-γ (rs1801282) were analyzed using Chi-square test, and the polymorphism was found significantly (p=0.05, Χ2=5.875) associated with IGT subjects. Allele frequency also shows significant association with IGT subjects in the Chi-square test (p=0.026, Χ2=2.248). When the waist-hip ratio was reanalyzed according to genotype variation, the waist-hip ratio was found significantly higher among subjects with heterozygous and homozygous variants of pro16Ala polymorphism. Therefore, our study concluded that PPAR-γ P12A variants might be associated with impaired glucose tolerance. It is also documented that higher waist to hip ratio in IGT subjects may associate with heterozygous (CG) and homozygous (GG) variants of Pro12Ala mutation in the PPAR-γ gene.&#x0D; Journal of Bangladesh Academy of Sciences, Vol. 44, No. 2, 179-189, 2020

Ayurvedic Herbal Preparation Supplementation Does Not Improve Metabolic Health in Impaired Glucose Tolerance Subjects; Observations from a Randomised Placebo Controlled Trial.

The increased usage of alternative Ayurvedic treatments as potential health-beneficial therapies emphasizes the importance of studying its efficacy in sound placebo-controlled intervention trials. An example of such a traditional Ayurvedic herbal preparation is Mohana Choorna, a mixture composed of 20 different herbs and used to prevent and treat type 2-diabetes (T2D). We studied the efficacy of “Mohana Choorna” on T2D-related parameters in subjects with impaired glucose tolerance. In a double blind, placebo-controlled cross-over trial, 19 overweight (BMI > 27 kg/m2) subjects aged 50–70 years with an impaired glucose tolerance received two four-week interventions, i.e., herbal or placebo with a four-week wash-out between interventions. HbA1c, glucose, insulin, triglycerides, cholesterol, blood pressure and augmentation index were measured before and after both interventions at fasting and during a glucose tolerance test. After both interventions, urine was collected to measure treatment exposure using LCMS-based metabolomics and whole genome gene-expression in adipose tissue of 13 subjects. The herbal intervention did not affect plasma glucose triglycerides, cholesterol, blood pressure or the augmentation index but showed a trend towards an increased insulin, HOMA-IR and postprandial insulin levels (p = 0.054, p = 0.056 and p = 0.095 respectively). An increase in expression of inflammation-related gene sets in adipose tissue was observed after the herbal intervention compared to placebo. Urine metabolomic analysis did not reveal a correlation of the presence of specific plant metabolites with “health markers”. Our findings suggest that there is no substantiating evidence to claim that four weeks’ use of the Ayurvedic herbal supplement Mohana Choorna beneficially affects glucose homeostasis.

Evaluation of therapeutic potential of Arhar honey (Cajanus cajan) in subjects with impaired glucose tolerance

Background: In Indian Medicine System, Arhar honey is believed as one of the valuable medicinal foods. Honey is being used since ancient times owing to its functional properties and nutritive value. Aims: We aimed to evaluate the effect of honey supplementation on fasting blood glucose (FBG) level and lipid profile of the subjects with impaired glucose tolerance (IGT) and healthy subjects. Methods: The selection of subjects was done through oral glucose tolerance test (World Health Organization/Food and Agriculture Organization, 1998). On the basis of blood glucose level, 28 subjects were selected by purposive random sampling and were divided into two groups. Group I included normal healthy subjects having FBG in the range of 70–100 mg/dl (n = 14), and Group II was comprised of subjects having FBG level between 100 and 125 mg/dl falling in the category of IGT (n = 14). 70 g honey was administered to subjects in both the groups on an empty stomach for 60 days and its effect on body weight, body mass index (BMI), blood pressure, FBG, glycated hemoglobin (HbA1c), and lipid profile was observed. Results: Honey administration lowered blood glucose levels and lipid levels in subjects with IGT and normal healthy subjects. Other benefits of honey administration include an increase in high-density lipoprotein cholesterol levels and a reduction in BMI. Conclusion: Consumption of honey has shown a reduction in body weight, BMI, FBG, HbA1c, and improvement in lipid profile in IGT subjects.

Manufacture of the Functional Noodle and its Effects on Postprandial 2h-blood Glucose and Serum Lipid Levels of Subjects with IGT

Background: The earliest determinant of progression to type 2 diabetes is a loss of early insulin secretion, a defect which results in postprandial hyperglycemia and is often believed to reflect insulin resistance. In Asian countries including our country, noodle is the traditional food which has been eaten from ancient times and is taken one or two times a day. The functional noodle is a staple meeting nutritional requirements for the prevention and treatment of Impaired Glucose Tolerance (IGT). Methods: FNs were prepared using the noodle making machine according to Barak et al. with slight modifications. After giving FNs prepared by three mixing ratios of main materials to the IGT-induced rats for 30 days, the levels of postprandial 2h-blood glucose in all experimental groups and control group were measured to determinate the optimal mixing ratio of FN. After the IGT subjects in experimental group ate 200g of FN (dried weight) in exchange for a lunch for 60 days, the levels of postprandial 2h-blood glucose and of TG and TC in serum were measured to compare with that in the control group who had not undergone control in their diet. Results: After 30 days of experiment, the levels of postprandial 2h-blood glucose in rats of pl group 4 were lowest. The levels of postprandial 2h-blood glucose in the control group that most of them had not undergone control in their diet were increased, but that in experimental group who had taken FN decreased from 30 days of experiment to be significantly different after 60 days. The concentrations of serum TC and TG of IGT subjects in the experimental group were decreased compared with that in the control group, but significance among two groups was achieved only in the concentration of serum TC. Conclusion: FN made in the 4:3:3 ratio of powder of corn, powder of bean cake defatted and powder of peeled whole potato is more effective to decrease the levels of postprandial 2h-blood glucose. FN is a staple type of functional food that could be used for the treatment of IGT.

314-OR: The Effect of Inhibition of Fatty Acid Spillover from Adipose Tissues on Organ-Specific Distribution of Dietary Fatty Acids

Excessive exposure of lean tissues to fatty acids leads to insulin resistance. Proper dietary fatty acids (DFA) storage in white adipose tissue (WAT) is thought to prevent lean tissue lipotoxicity. We showed that WAT storage of DFA was impaired in IGT (impaired glucose tolerance) and was associated with greater cardiac DFA uptake and subclinical left-ventricular dysfunction. Whether WAT DFA storage directly impacts cardiac DFA uptake in IGT subjects is not known. We aimed at investigating how inhibition of intracellular lipolysis affected WAT DFA storage, spillover, and cardiac DFA uptake. We recruited 23 participants: 12 IGT, 5 women/7 men, aged (mean ± sem) 64±2.5, BMI= 34.9±3.1 kg/m2 and 11 NGT, 7 women/4 men, aged 62±2, BMI= 30.4±1.6 kg/m2. Cardiac DFA uptake and whole-body organ-specific DFA partitioning were assessed using PET/CT method with oral administration of 18FTHA. NEFA appearance and WAT DFA spillover were measured using stable isotope tracer methods. Nicotinic acid (NA) was used to inhibit WAT DFA spillover. In both groups, NA decreased AUC DFA spillover rate (-31%±19, p=0.014) and AUC NEFA appearance rate (-28%±10, p=0.0002). In NGT group, NA decreased muscle and liver DFA distribution by 30%±8 (p=0.007) and 25%±8 (p=0.024), respectively, and increased WAT DFA distribution by 48%±8 (p=0.001). The same trend was observed in IGT group, but with blunted differences in WAT DFA storage vs. NGT (p=0.73). NA-induced increase in visceral WAT DFA distribution was correlated negatively with change in AUC. Nonesterified fatty acids (NEFA) appearance rate (ρ=-0.58, p=0.004). In both groups, NA did not significantly affect cardiac DFA distribution. In both groups, we estimated that DFA spillover may account for 31%±23 of DFA reaching lean organs over a 6-hour period after meals. Inhibition of WAT DFA spillover enhances DFA WAT storage and reduces liver and skeletal muscle, but not cardiac DFA partitioning. Disclosure E. Montastier: None. C. Noll: None. R. Ye: None. M. Amrani: None. F. Frisch: None. M. Fortin: None. L. Bouffard: None. O. Sarrhini: None. S. Phoenix: None. B. Guerin: None. E.E. Turcotte: None. A.C. Carpentier: Advisory Panel; Self; HLS Therapeutics, Inc.

Dysfunction of Persisting β Cells Is a Key Feature of Early Type 2 Diabetes Pathogenesis

Type 2 diabetes is characterized by peripheral insulin resistance and insufficient insulin release from pancreatic islet β cells. However, the role and sequence of β cell dysfunction and mass loss for reduced insulin levels in type 2 diabetes pathogenesis are unclear. Here, we exploit freshly explanted pancreas specimens from metabolically phenotyped surgical patients using an in situ tissue slice technology. This approach allows assessment of β cell volume and function within pancreas samples of metabolically stratified individuals. We show that, in tissue of pre-diabetic, impaired glucose-tolerant subjects, β cell volume is unchanged, but function significantly deteriorates, exhibiting increased basal release and loss of first-phase insulin secretion. In individuals with type 2 diabetes, function within the sustained β cell volume further declines. These results indicate that dysfunction of persisting β cells is a key factor in the early development and progression of type 2 diabetes, representing a major target for diabetes prevention and therapy.

Peptide hormones and risk for future cardiovascular events among prediabetics: a 20-year follow-up in the OPERA study

Background: Prediabetes has proven to have many unfavourable impacts on the cardiovascular system.Methods: The OPERA (Oulu Project Elucidating Risk of Atherosclerosis) study included 1045 middle-aged subjects followed from the years 1990–1993 to 2014. The focus was on peptide hormones.Results: Plasma resistin levels were higher among prediabetics (p = .001), particularly impaired glucose tolerance (IGT) (p < .001), but not impaired fasting glucose (IFG) patients than among normal glucose tolerance (NGT) or diabetes groups. Diabetics showed lower resistin levels than IGT subjects (p < .001). IGT or diabetes groups showed lower adiponectin and higher leptin levels compared to the NGT group (p < .001). The IFG group had the highest blood pressure and left ventricular mass index, even higher than the diabetic group. Diabetics had the highest, prediabetics (IFG + IGT) intermediate and NGT the lowest risk for CVD events during follow-up (p < .001). Among prediabetics, high plasma ghrelin was an independent predictor of CVD events (p < .05) in the Cox regression analysis although it did not significantly improve either classification or discrimination of the patients.Conclusions: Among glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics. Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.KEY MESSAGEAmong glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics.Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.

Elevated 1-h post-load plasma glucose levels in normal glucose tolerance children with obesity is associated with early carotid atherosclerosis

ContextEvidence suggests that the 1-h post-load plasma glucose (1-h PG) ≥155mg/dL during an oral glucose tolerance test (OGTT) predicts development of type 2 diabetes (T2DM) and associated complications, among adults with normal glucose tolerance (NGT), but relevant data on children is scarce. ObjectivesTo investigate whether NGT children with obesity whose 1-h PG is ≥155mg/dL have an increased carotid intima-media thickness (IMT) and exhibit non-alcoholic fatty liver disease (NAFLD) diagnosed by ultrasonography, as compared with NGT subjects with 1-h PG <155mg/dL and impaired glucose tolerance (IGT). MethodsCardio-metabolic profile, OGTT, measurements of carotid IMT and liver ultrasonography were analyzed in 171 non-diabetic children with obesity. Subjects were divided into 3 groups: NGT subjects with a 1-h PG <155mg/dL, NGT subjects with a 1-h PG ≥155mg/dL, and IGT subjects. ResultsAs compared with NGT individuals with a 1-h PG <155mg/dL, NGT individuals with a 1-h PG ≥155mg/dL exhibited higher carotid IMT (0.75±0.15mm vs. 0.68±0.15mm; p<0.05). No significant differences were observed in carotid IMT between IGT and NGT subjects with a 1-h PG ≥155mg/dL (0.75±0.18mm vs 0.75±0.15mm; p>0.05). Of the three glycemic parameters, 1-h and 2-h PG, but not fasting glucose, were significantly correlated with carotid IMT. There were no significant differences for increased risk of having NAFLD between the three groups. ConclusionsThese data suggest that a value of 1-h PG ≥155mg/dL in children and adolescents with obesity is as important as IGT with respect to cardiovascular risks.

The association between omentin and diabetes: a systematic review and meta-analysis of observational studies.

AimsA number of studies have examined the association between the serum levels of omentin and diabetes, but the findings have been inconclusive. Herein, we systematically reviewed available observational studies to elucidate the overall relationship between omentin and diabetes, including type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and impaired glucose tolerance (IGT) among adolescent and adult population.MethodsPubMed, Cochrane’s Library, Science Direct, Scopus, Google Scholar, and ISI Web of Science databases were searched for all available literature until January 2019 for studies assessing the association between omentin and diabetes. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of each study.ResultsA total of 28 articles met the inclusion criteria and were included in our systematic review and meta-analysis. There was a significant association between serum omentin and diabetes (WMD−1.68; 95% CI, −2.17 to −1.19; P<0.001). The result of our sub-group analysis based on participants’ health status revealed that omentin was significantly lower in T2DM and IGT subjects but not in T1DM ones compared to healthy controls.ConclusionWe found that serum omentin level is significantly lower in T2DM and IGT patients but not in T1DM ones. These data could be used by clinicians for early diagnosis and management of diabetes. Furthermore, we need more clinical trials to investigate new agents which could influence omentin levels.

STUDY OF SERUM ADIPONECTIN LEVEL IN IMPAIRED GLUCOSE TOLERANCE SUBJECTS.

13Jun 2019 STUDY OF SERUM ADIPONECTIN LEVEL IN IMPAIRED GLUCOSE TOLERANCE SUBJECTS. Poonam Yadav and G.G. Kaushik. M.Sc. (Med.) Student, Department of Biochemistry, J.L.N. Medical College, Ajmer (Rajasthan). Rajasthan University of Health Sciences, Jaipur. Senior Professor, Department of Biochemistry, J.L.N. Medical College, Ajmer (Rajasthan). Rajasthan University of Health Sciences, Jaipur.

Serum IL-6 and sIL-6R in type 2 diabetes contribute to impaired capillary-like network formation.

We hypothesized that the serum from individuals with type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) would reduce in vitro capillary-like network formation compared with normal glucose tolerance (NGT) serum and that this would occur along with higher serum concentrations of inflammatory cytokines and lower concentrations of angiogenic growth factors. Subjects were sedentary, older (55-65 yr) adults with NGT, IGT, or T2DM (n = 10/group) matched for body mass index. Human retroviral telomerized endothelial cells (HRVT-ECs) or coronary artery endothelial cells (CECs) were used in a capillary-like network formation assay using endothelial basal medium supplemented with 7.5% serum. Quantification of HRVT-EC network length indicated that serum from the T2DM group resulted in 32 and 35% lower network formation than when using serum from the NGT and IGT groups, respectively (P < 0.05). Serum from T2DM subjects resulted in CEC network formation that was 11 and 8% lower than when using serum from NGT and IGT subjects, respectively (P < 0.05). Analysis of serum cytokines indicated that IL-6 was 41% and 49% higher in the IGT and T2DM groups, respectively, compared with the NGT group (P < 0.05) and there was a trend for higher soluble interleukin-6 receptor (sIL-6R; P = 0.06) and IL-8 (P = 0.08) in the T2DM serum compared with NGT. The use of recombinant IL-6 and sIL-6R at concentrations detected in the T2DM serum also reduced capillary network formation compared with NGT concentrations (P < 0.05). These results suggest that IL-6 and sIL-6R present in the serum of T2DM individuals impair in vitro endothelial cell function across different cell lines. Our findings may have implications for the microvascular complications associated with T2DM.NEW & NOTEWORTHY Higher concentrations of serum factors, specifically Interleukin-6 and its soluble receptor found in individuals with type 2 diabetes (T2DM) appear to impair endothelial cell capillary-like network formation compared with those present in serum from individuals with impaired glucose tolerance and normal glucose tolerance. This may have implications for the vascular complications associated with T2DM.

Role of Dietary Macronutrients and Fatty Acids in Obesity and Metabolic Risk in Older Adults (P08-026-19)

ObjectivesThe aim of the study was to examine the role of dietary consumption of different types of fatty acids on metabolic risk factors and regional fat deposition in older men and women. We hypothesized that saturated fatty acid (SFA) intake, ratio of monounsaturated fatty acids (MUFA) to polyunsaturated fatty acids (PUFA), and total fat intake, as well as proportion of energy derived from fat, would be associated with markers of insulin resistance, hyperlipidemia, and ectopic fat. MethodsSedentary, obese (Body Mass Index: 29–48 kg/m2) adults (N = 20) aged 45–78 years underwent two-hour oral glucose tolerance test, blood draw, DXA scan, and CT scan of the abdomen and mid-thigh. Seven-day diet records were analyzed with NutritionistPro software and the USDA Foodapedia feature of the Supertracker program. ResultsSubjects had low fitness levels (VO2 max = 23.5 ±2.4 mL/kg/min) and high total body fat (43.5 ± 1.7%) with abdominal obesity (visceral adipose tissue area = 192.4 ± 18 cm2, subcutaneous abdominal adipose area = 465.4 ± 29 cm2) and intermuscular adipose tissue (IMAT) area in thigh (150.1 ± 17 cm2). The average macronutrient composition of the diet was high in fat (fat as a % of total kcal = 35.5) with SFA, MUFA, and PUFA were respectively represented as 33.0, 34.8, and 22.1% of total fat intake. The average MUFA to PUFA ratio was 1.66. There were no differences in fatty acid intake between subjects with normal glucose tolerance and impaired glucose tolerance subjects. The ratio of MUFA to PUFA was positively correlated with higher fasting glucose (r = 0.42, P = 0.06), glucose intolerance (r = 0.43, P = 0.06), and serum cholesterol (r = 0.48, P = 0.03). PUFA intake as a percentage of fat intake was associated with lower serum cholesterol (r = –0.44, P = 0.05). Associations between diet composition with body composition (abdominal fat, IMAT) were not found to be uniformly significant among a homogenous sample of obese, sedentary subjects with diets high in proportion of lipid. ConclusionsDietary fatty acid intake, specifically MUFA unbalanced by PUFA, was associated with glucose intolerance and increased serum cholesterol, and therefore may confer increased risk for diabetes among obese, sedentary individuals. Future investigation of food sources, or context of dietary lipids, could lead to individualized dietary recommendations to promote healthy eating habits and potentially alter metabolic risk. Funding SourcesSupported by grant awards from the Department of Veteran’s Affairs and the National Institute of Health.

Subjects with impaired glucose tolerance returned to normal glucose status for six years had lower long-term risk of diabetes: 20 years follow up of Daqing diabetes prevention study

Objective: To explore the influence of lifestyle intervention on long-term diabetes in subjects with impaired glucose tolerance (IGT) returned to normal glucose tolerance (NGT) within 6 years. Methods: A total of 577 subjects (aged 25-74 years old) with IGT in Daqing were enrolled and randomly assigned to control, and diet, exercise and diet plus exercise groups in a six-year intervention trial in 1986. Subjects who were non-diabetic at the end of the intervention were followed up for additional 14 years. Results: Among all the subjects, 41.38% of them who had returned to NGT from IGT within 6 years maintained NGT status after 20 years, and had a lower incidence of diabetes than subjects maintained IGT status (46.55% vs. 75.25%). Of note, in the intervention group, the percentage of participants developed diabetes in the NGT subjects was significantly lower than that in the IGT group (43.71% vs. 76.25%) after 20 years. There was high long-term risk for diabetes in the IGT subjects after the adjustment of age, sex and baseline glucose (HR=1.81, 95%CI 1.27-2.58, P=0.001), whereas in the non-intervention group, no significant difference could be viewed in long-term diabetic risk between subjects maintained IGT status and those returned to NGT (71.43% vs. 65.22%) after adjusting of the same confounders (HR=1.03, 95%CI 0.45-2.35, P=0.94). Conclusions: IGT subjects who had returned to NGT in early years had lower risk for future diabetes than those who remained IGT. However, this beneficial effect could only be viewed in the intervention group, but not in the non-intervention group.