Independent Risk Factor For Type Research Articles

1666-P: Metabolic Characteristic of Elevated One-Hour Plasma Glucose Levels during a 75g Oral Glucose Tolerance Test in the Nonobese Japanese Men

It has been shown that subjects with normal glucose tolerance (NGT) but elevated 1-hour glucose level ≧155 mg/dl during a 75g oral glucose tolerance test (75g OGTT) is an independent risk factor for type 2 diabetes. In Caucasian, subjects with elevated 1-h glucose were characterized by adiposity with lower insulin sensitivity and impaired beta-cell function. While type 2 diabetes in Asians is frequently affected in non-obese (BMI<25 kg/m2) subjects, the characteristics of non-obese Asians with elevated 1-h glucose are totally unknown. Here, we studied 59 non-obese Japanese men with NGT. Based on the level of 1-hour glucose level during 75g OGTT, we divided the subjects into Low-1 hour group (< 155mg/dl) and High-1 hour group (≧155mg/dl). We measured ectopic fat in muscle and liver and subcutaneous and viscera fat areas by 1H-MRS and MRI, respectively. We also measured tissue specific insulin sensitivity by 2 step hyperinsulinemic-euglycemic clamp. Insulinogenic index (0.66±0.30 vs. 1.41±1.21ΔInsulin0-30 min/ΔGlucose 0-30min, p=0.02) was significantly lower and area under the curve of glucose and insulin during 75g OGTT were significantly higher in High-1 hour group than Low-1 hour group (Figure). However, other parameters including insulin sensitivity and ectopic fat in muscle and liver, subcutaneous and viscera fat areas were comparable between the groups. These data suggest that non-obese Japanese men with High-1 hour glucose are characterized by impaired early-phase insulin secretion and subsequent hyperinsulinemia. Insulin resistance and abnormal fat distribution are not evident in this population. Disclosure M. Sato: None. Y. Tamura: None. H. Kaga: None. Y. Someya: None. S. Kakehi: None. N. Yamasaki: None. D. Sugimoto: None. S. Kadowaki: None. R. Suzuki: None. Y. Furukawa: None. K. Takeno: None. T. Funayama: None. R. Kawamori: None. H. Watada: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Pfizer Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Pharmaceutical Europe Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanwa Chemical Industry Co. Ltd., Takeda Pharmaceutical Company Limited.

2251-PUB: Relationship between Type 2 Diabetes and Dyslipidemia in Adult Residents of Minhang District, Shanghai: A Multistage, Stratified Cluster Sampling Survey

Objective: To investigate the relationship between type 2 diabetes and dyslipidemia in adult residents of Minhang District, Shanghai. Methods: A multistage, stratified cluster sampling survey were conducted among 3099 adult residents aged 35 and above in Minhang District. The prevalence rate should be adjusted according to the population distribution of the Sixth National Population census data in this area. Logistic regression analysis was used for multivariate analysis. Results: The adjusted prevalence rate of type 2 diabetes and dyslipidemia were 18.18% and 50.61%, respectively. The increased rates of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were 28.03%, 19.56% and 3.56%, respectively, and the decreased rate of high-density lipoprotein cholesterol (HDL-C) was 14.32%. TC, TG and LDL-C were positively correlated with fasting blood glucose (FBG) with linear correlation coefficients 0.068, 0.190 and 0.049, respectively. While HDL-C was negatively correlated with FBG with linear correlation coefficient -0.076. The relationship between the TC, TG, LDL-C and HDL-C and the 2-hours blood glucose (2hBG) after oral glucose tolerance test (OGTT) was the same as that between the TC, TG, LDL-C and HDL-C and the FBG and the linear correlation coefficients were 0.121, 0.166, 0.116 and -0.045, respectively. Dyslipidemia and higher TG were independent risk factors of type 2 diabetes (OR=1.69, 95% CI:1.32-2.17; OR=1.53, 95% CI:1.21-1.94), adjusting sex, age, education level, occupation, smoking, drinking, BMI and hypertension. Conclusion: Dyslipidemia is closely associated with type 2 diabetes among adult residents in Minhang District. Comprehensive prevention and control measures for dyslipidemia and type 2 diabetes should be carried out. Disclosure T. Liang: None. D. Xu: None. B. Yao: None.

245-LB: Association between the Risk of T2D Incidence and the Genetic Variants of GCK and HDAC4 Genes Interacting with Alcohol Consumption in Korea

Chronic alcohol consumption is well-known as an independent risk factor for type 2 diabetes (T2D), which is related with impaired glucose homeostasis and insulin resistance. The identification of genetic variants and the association with diseases may help to explain the genetic etiology of type 2 diabetes. In this study, we aimed to search for the single nucleotide polymorphisms (SNPs) associated with T2D risk, which also interact with alcohol consumption. We conducted genome-wide interaction study using the Korea Association Resource (KARE) data. We found that two SNPs, HDAC4 (rs3791370) and GCK (rs758989) are associated with T2D and also interact with alcohol consumption (odds ratio [OR] 1.74, and OR 1.37, respectively). We further investigated the association between these SNPs and response to alcohol consumption in risk of T2D incidence. In alcohol consumption group, these SNPs significantly increased the risk of T2D incidence compared with nonalcohol consumption group (HDAC4; hazard ratio [HR] 1.29, GCK; HR 1.34). Moreover, genotype association analysis showed that the presence of the risky allele (hetero risky allele [CR] + minor homo risky allele [RR]) in GCK SNP significantly increased the risk of T2D incidence (1.47, p = 0.032) compared with major homo C allele [CC] in alcohol consumption group after adjustment with age, BMI, smoking, physical activity, and history of diabetes. However, presence of the risky allele in HDAC4 SNP marginally increased the risk of T2D incidence (1.47, p = 0.0652). Based on our data, we suggest that HDAC4 and GCK SNPs could be a potential factor for increase of T2D incidence risk, which may be helpful to better understand the genetic basis of T2D in association with alcohol consumption. Disclosure J. Yun: None. H. Jang: None. M. Yoo: None. H. Lee: None. S. Park: None. Funding Korea National Institute of Health (2019-NI088-00)

226-LB: HOMA-ß and ß-Cell Activity in Early and Late Phase during an OGTT Are Independent Risk Factors of Type 2 Diabetes in Japanese Americans

The β-cell plays a major role in type 2 diabetes (T2DM). HOMA-β reflects fasting β-cell activity. Insulin responses during an OGTT reflect β-cell activity during glucose loading, which has two phases, early and late. HOMA-β, early, and late β-cell activity have different pathophysiologies. However, no research has examined whether HOMA-β and early and late phase β-cell activity during an OGTT are independently associated with the risk of T2DM. In a prospective cohort study, 415 nondiabetic Japanese-American men and women were followed for 10-11 years. β-cell activity was assessed by HOMA-β [fasting insulin × 360/(fasting glucose − 63)] as fasting activity, the insulinogenic index (IGI) [?insulin (30-0 min)/?glucose (30-0 min)] during an OGTT as early phase activity, and (area under the curve (AUC) of insulin 60-120 min)/(AUC glucose 60-120 min) as late phase activity. Insulin sensitivity was estimated by Matsuda index [10000/square root of ((fasting glucose) × (fasting insulin) × (AUC glucose 0-120 min/120) × (AUC insulin 0-120 min/120))]. T2DM was diagnosed as fasting plasma glucose level ≥126 mg/dL, 2-hour glucose level ≥200 mg/dL, or taking glucose-lowering medications. During the 10-11 year follow-up, 95 cases of T2DM occurred. HOMA-β, IGI, and late phase β-cell activity were all independently associated with the risk of T2DM. Multiple-adjusted odds ratios of T2DM for tertile 1, 2, and 3 of HOMA-β were 1.00 (reference), 0.25 (95% CI, 0.11-0.57), and 0.14 (0.05-0.37), respectively; those of IGI were 1.00, 0.35 (0.17-0.75), and 0.19 (0.07-0.47), respectively; and those of late phase β-cell activity were 1.00, 0.34 (0.14-0.82), and 0.16 (0.05-0.53), respectively, in the model that included HOMA-β, IGI, late phase β-cell activity, Matsuda index, age, BMI, sex, and family history of T2DM. In conclusion, higher β-cell activity while fasting and in both the early and late phase during an OGTT were all independently associated with a lower risk of T2DM. Disclosure T. Shimojo: None. C. Izumi: None. K.K. Sato: None. D.L. Leonetti: None. S.E. Kahn: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S. Consultant; Self; Neurimmune. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S. W.Y. Fujimoto: None. E.J. Boyko: None. T. Hayashi: None.

Association between serum total bilirubin levels and the risk of type 2 diabetes mellitus

AimTo confirm whether serum bilirubin is an independent risk factor of type 2 diabetes mellitus (T2DM) onset in patients with impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT). MethodsThis was a prospective cohort study carried out at the Diabetic Identification Center of Tianjin Metabolic Diseases Hospital. Serum total bilirubin (TBIL) was measured at baseline and the patients were grouped according to baseline bilirubin quartiles. The outcome was the confirmation of T2DM by oral glucose tolerance test (OGTT) during the 3-year follow-up. Logistic regression was used to determine the risk factors for T2DM development and whether bilirubin levels are independently associated with T2DM development. ResultsFinally, 523 patients were analyzed. After 3 years, 310 participants were diagnosed with diabetes based on OGTT. Baseline quartiles of total bilirubin were inversely associated with diabetes risk, even after multivariable adjustment. The adjusted ORs for diabetes were 1.0 (reference), 0.83 (95% CI 0.74–0.96), 0.78 (95% CI 0.68–0.90), 0.74 (95% CI 0.64–0.87) for the 1st, 2nd, 3rd, and 4th quartiles of baseline serum total bilirubin, respectively (P < 0.001). ConclusionIn patients with IFG or IGT, low levels of serum total bilirubin were associated with a significantly increased risk of T2DM.

Suboptimal health status as an independent risk factor for type 2 diabetes mellitus in a community-based cohort: the China suboptimal health cohort study.

The prevalence of diabetes, constituted chiefly by type 2 diabetes mellitus (T2DM), is a global public health threat. Suboptimal health status (SHS), a physical state between health and disease, might contribute to the progression or development of T2DM. We conducted a prospective cohort study, based on the China Suboptimal Health Cohort Study (COACS), to understand the impact of SHS on the progress of T2DM. We examined associations between SHS and T2DM outcomes using multivariable logistic regression models and constructed predictive models for T2DM onset based on SHS. A total of 61 participants developed T2DM after an average of 3.1years of follow-up. Participants with higher SHS scores had more T2DM outcomes (p =0.036). Moreover, compared with the lowest quartile of SHS scores, participants with fourth, third, and second quartile SHS scores were found to be associated with a 1.7-fold, 1.6-fold, and 1.5-fold risk of developing T2DM, respectively. The predictive model constructed with SHS had higher discriminatory power (AUC = 0.848) than the model without SHS (AUC = 0.795). The present study suggests that a higher SHS score is associated with a higher incidence of T2DM. SHS is a new independent risk factor for T2DM and has the capability to act as a predictive tool for T2DM onset. The evaluation of SHS combined with the analysis of modifiable risk factors for SHS allows the risk stratification of T2DM, which may consequently contribute to the prevention of T2DM development. These findings might require further validation in a longer-term follow-up study.

Rapamycin improves bone mass in high-turnover osteoporosis with iron accumulation through positive effects on osteogenesis and angiogenesis.

Iron accumulation is an independent risk factor for type I osteoporosis, but the molecular mechanisms of the phenomenon are not well defined, and effective therapy has not been reported. Here, we found that the level of mTOR was increased both in wild-type mouse models with iron accumulation and transgenic mouse models (Hepc-/-) of high-turnover osteoporosis with iron accumulation. We show that an increased level of mTOR can depress osteogenesis and angiogenesis by Cxcl9 both in bone and in vitro. Suppression of mTOR in mouse models by rapamycin and in vitro by siRNA transfection recovered both osteogenesis and angiogenesis. These findings revealed the role of mTOR in osteogenesis and angiogenesis in high-turnover osteoporosis with iron accumulation and showed that rapamycin targeting of mTOR ameliorates osteogenesis and angiogenesis to improve bone mass.

Altered Dairy Protein Intake Does Not Alter Circulatory Branched Chain Amino Acids in Healthy Adults: A Randomized Controlled Trial.

Dairy, as a major component of a high protein diet, is a critical dietary source of branched chain amino acids (BCAA), which are biomarkers of health and diseases. While BCAA are known to be key stimulators of protein synthesis, elevated circulatory BCAA is an independent risk factor for type 2 diabetes mellitus. This study examined the impact of altered dairy intake on plasma BCAA and their potential relationship to insulin sensitivity. Healthy adults (n = 102) were randomized to receive dietary advice to reduce, maintain, or increase habitual dairy intake for 1 month. Food intake was recorded with food frequency questionnaires. Self-reported protein intake from dairy was reported to be reduced (−14.6 ± 3.0 g/day), maintained (−4.0 ± 2.0 g/day) or increased (+13.8 ± 4.1 g/day) according to group allocation. No significant alterations in circulating free amino acids (AA), including BCAA, were measured. Insulin sensitivity, as assessed by homeostatic model assessment-insulin resistance (HOMA-IR), was also unaltered. A significant change in dairy protein intake showed no significant effect on fasting circulatory BCAA and insulin sensitivity in healthy populations.

Gender differences of visceral fat area for predicting incident type 2 diabetes in Koreans

AimsVisceral fat accumulation is known to be an independent risk factor for type 2 diabetes. We aimed to determine the optimal cutoff values of visceral fat area (VFA) for predicting incident type 2 diabetes in Koreans. MethodsOur study population consisted of 13,004 individuals initially free of type 2 diabetes the ages between 20 and 69 years, who underwent routine health examinations between January 2012 and December 2012 and returned for follow–up examinations between January 2016 and December 2016. VFA values were derived from bioelectrical impedance analysis (BIA) at baseline. ResultsDuring a median follow–up of 4.02 years, a total of 481 (4.6% for men and 2.3% for women) incident cases of type 2 diabetes were identified. According to the receiver operating characteristic (ROC) curve, the optimal VFA cutoff values for predicting incident type 2 diabetes were 118.8 cm2 in men and 82.6 cm2 in women, respectively. In a multivariable–adjusted model including obesity and glycemic status, the odds ratios (ORs) of VFA over 120 cm2 in men and 80 cm2 in women were 1.72 and 3.56, respectively. ConclusionsHigher VFA at baseline was an independent risk factor for developing type 2 diabetes and the optimal VFA cutoff values were markedly different between men and women. Therefore, sex–specific reference values for visceral fat obesity such that men with a VFA ≥120 cm2 and women with a VFA ≥80 cm2 should be considered to predict incident type 2 diabetes.

Targeting Postprandial Hyperglycemia With Physical Activity May Reduce Cardiovascular Disease Risk. But What Should We Do, and When Is the Right Time to Move?

Physical inactivity and excessive postprandial hyperglycemia are two major independent risk factors for type 2 diabetes and cardiovascular-related mortality. Current health policy guidelines recommend at least 150 min of physical activity per week coupled with reduced daily sedentary behavior by interrupting prolonged sitting with bouts of light activity every 30-min. This evidence-based strategy promotes health and quality of life. Since modern lifestyle enforces physical inactivity through motorized transportation and seated office working environments, this review examines the practical strategies (standing, walking, stair climbing, and strength-based circuit exercises) for reducing sitting time and increasing activity during the workday. Furthermore, since postprandial hyperglycemia poses the greatest relative risk for developing type 2 diabetes and its cardiovascular complications, this review examines a novel hypothesis that interrupting sitting time would be best focused on the postprandial period in order to optimize blood glucose control and maximize cardiometabolic health. In doing so, we aim to identify the science gaps which urgently need filling if we are to optimize healthcare policy in this critical area.

Sex Differences in the Impact of Obstructive Sleep Apnea on Glucose Metabolism.

Objectives: Obstructive sleep apnea (OSA) is more prevalent in men and is an independent risk factor for type 2 diabetes. We aimed to determine if there are sex differences in the impact of OSA on glucose metabolism in nondiabetic overweight and obese adults.Methods: One hundred and forty-five men and women (age 33.4 ± 0.6, BMI 37.2 ± 0.7, 70.3% blacks) from the community underwent in-laboratory polysomnography. Severity of OSA was assessed by the apnea-hypopnea index (AHI). Glucose tolerance was assessed using fasting glucose, 1-h glucose, 2-h glucose and the area under the curve (AUC) during the 2-h oral glucose tolerance test (OGTT). Fasting insulin resistance was assessed by HOMA-IR, and insulin sensitivity during the OGTT was assessed by the Matsuda Index. Pancreatic beta-cell function was assessed by fasting HOMA-%B and by AUCinsulin/glucose, insulinogenic index, and oral disposition index (DIoral) during the OGTT. All comparisons were adjusted for age, BMI, race and severity of OSA.Results: There were no significant demographic differences between men and women without OSA. Men and women with OSA were similar in age, BMI, and severity of OSA, but there were more black women with OSA. Compared to women with OSA, men with OSA had significantly higher fasting glucose, 1-h glucose levels, AUCglucose, and AUC for insulin secretion rate (AUCISR) but similar 2-h glucose levels. These differences persisted in adjusted analyses. Men with OSA secreted significantly more insulin than women with OSA in order to achieve similar glucose levels. Men with OSA had significantly worse beta cell function as measured by the DIoral than women with OSA. In contrast, there were no significant sex differences in measures of glucose tolerance and beta-cell function in participants without OSA.Conclusion: Men with OSA secreted more insulin compared to women with OSA in order to maintain glucose homeostasis. The adverse impact of OSA on beta-cell responsiveness was larger in men, which may result in an overall greater risk of type 2 diabetes compared to women.

Type 2 Diabetes Mellitus: Integrative Analysis of Multiomics Data for Biomarker Discovery.

Increased fasting plasma glucose (FPG) is an independent risk factor for type 2 diabetes mellitus (T2DM). The development of systems biology technologies for integration of multiomics data is crucial for predicting increased FPG levels. In this case-control study, immunoglobulin (Ig) G glycosylation profiling and genome-wide association analyses were performed on 511 participants, and among them 76 had increased FPG (aged 47.6 ± 6.14 years), and 435 had decreased or fluctuant FPG (aged 47.9 ± 6.08 years). We identified nine single nucleotide polymorphisms (SNPs) in five genes (RPL7AP27, SNX30, SLC39A12, BACE2, and IGFL2) that were significantly associated with increased FPG (odds ratios 1.937-2.393). Moreover, of the 24 glycan peaks (GPs), GPs 3, 8, and 11 presented positive trends with increased FPG levels, whereas GPs 4 and 14 presented negative trends. A significant improvement of predictive power was observed when adding 24 IgG GPs to 9 SNPs with the area under the curve increased from 0.75 to 0.81. This report shows that the combination of candidate SNPs with IgG glycomics offers biomarker potentials for T2DM. The substantial predictive power obtained from integrating genomics and glycomics biomarkers suggests the feasibility of applying such multiomics strategies to enable predictive, preventive, and personalized medicine for T2DM.

Time-to-Peak C-Peptide and Peak Glucose during an Oral Glucose Tolerance Test (OGTT) Are Independent Risk Factors for Type 1 Diabetes (T1D) in Antibody-Positive (Ab+) Individuals

Peak C-peptide (C-P) and glucose levels are known predictors of T1D, but T1D prediction by times to those peak levels has not been studied. We thus assessed T1D prediction by times to peak C-P or glucose during OGTTs in 709 Ab+ Diabetes Prevention Trial-type 1 participants with 2-hour OGTTs [mean age: 13.9±9.6 years; BMI percentile (%ile): 59.3±29.0; 56% male]. Log rank testing and Cox regression with adjustments for age, sex, BMI %ile, proband relation, HLA, and Ab number were used. Risks were higher for time to peak C-P &amp;gt;60 mins [HR: 1.96 (CI: 1.49-2.63), p&amp;lt;0.001)] and for time to peak glucose &amp;gt;30 mins [HR: 2.22 (1.67-2.94), p&amp;lt;0.001)]. With time to peak C-P and peak C-P as covariates, T1D associations were greater for time to peak C-P (X2=22.8 vs. 9.3, both p&amp;lt;0.001). Time to peak glucose and peak glucose associations also remained significant (both p&amp;lt;0.001). Findings were validated in Ab+ relatives in the TrialNet Pathway to Prevention study (Figure); those with a peak C-P &amp;gt;60 mins or a peak glucose &amp;gt;30 mins had higher risk (both p&amp;lt;0.001). In conclusion, Ab+ relatives with delayed peak C-P or glucose are at higher T1D risk, independent of peak levels. Moreover, the time to peak C-P appears to be more predictive than the peak level. Times to peak C-P and glucose have potential use as predictors of T1D and as markers for progression. Disclosure H.M. Ismail: None. P. Xu: None. C. Evans-Molina: None. J.P. Palmer: None. J. Sosenko: None.

Does bariatric surgery influence plasma levels of fetuin-A and leukocyte cell-derived chemotaxin-2 in patients with type 2 diabetes mellitus?

BackgroundFetuin-A and leukocyte cell-derived chemotaxin-2 (LECT-2) are liver-derived proteins. Fetuin-A is an independent risk factor for type 2 diabetes (T2D) and obese patients with T2D have higher plasma fetuin-A levels than those without T2D. LECT-2 has positive correlation with the severity of both obesity and insulin resistance. The changes in plasma fetuin-A are not consistent after bariatric surgery and no studies have investigated the changes in LECT-2 on the obese patients with T2D after bariatric surgery.MethodsOverall, 18 patients undergoing gastric bypass (GB) and 16 patients undergoing sleeve gastrectomy (SG) were enrolled. The fasting plasma fetuin-A and LECT-2 levels were measured at baseline, one week, three months, and one year after surgery.ResultsBoth the GB and SG groups significantly decreased the body mass index (BMI), waist-to-hip ratio, a body shape index; the triglyceride, fasting blood sugar (FBS), hemoglobin A1c, C-peptide levels; and homeostatic model assessment (HOMA-IR) one year after surgery. The SG group showed a decreasing trend in plasma fetuin-A levels one year after SG surgery. There are no significant changes in LECT-2 one year after either GB or SG. Fetuin-A had a near significant negative relationship with insulin (P = 0.056) and HOMA-IR (P = 0.050) in the SG group. Changes in fetuin-A had a significant positive relationship with changes in BMI (P = 0.031) and waist-to-hip ratio (P = 0.031) in the GB group and had a near significant positive correlation with FBS (P = 0.051) in the SG group.DiscussionNeither GB nor SG modifies plasma levels of plasma fetuin-A or LECT-2 in T2D patients after surgery. The changes in plasma fetuin-A have a positive correlation with those of the BMI and waist-to-hip ratio 12 months after GB.

Behavioral and familial predictors of diabetes mellitus in adults aged 20–69 in Yazd, Iran during 2014–2015

IntroductionThe present study aimed to assess the behavioral and familial predictors of diabetes mellitus as well as their interaction in the risk of diabetes mellitus type2. MethodsThe present cross-sectional study was conducted using the Yazd health study (YaHS) data which was collected in 2013–14. Statistical population of this study consisted of all 9340 individuals aged between 20 and 69 in Yazd City. Logistic regression was used to determine behavioral factors and family history of diabetes and their interaction in the risk of diabetes. ResultsIn the present study, age, family history of type 2 diabetes, waist-to-hip ratio, BMI, educational level, physical activity and smoking were considered as the risk factors for type 2 diabetes.There was a significant interaction(negative interaction) between family history of diabetes and other risk factors only for BMI, so that the risk of developing type-2 diabetes was lower in the presence of two risk factors- family history of diabetes and BMI- than the risk of diabetes in the presence of each of these factors. ConclusionResults of the present study suggested that despite the consideration of family history as an independent risk factor for type 2 diabetes, if it was used as a tool to raise the awareness and sensitivity in people with type 2 diabetes, it would reduce the risk of developing this type of diabetes in people who had other risk factors for type 2 diabetes.

Comparative proteomics of Zebrafish liver in 5 POPs mixture exposure

Type 2 diabetes mellitus (T2DM) is a major public medical problem with ill‐defined pathophysiological mechanisms and multifactorial etiology. Increasing epidemiological studies have consistently suggested an association between persistent organic pollutant (POPs) and risk of developing T2DM. The POPs have also been reported to negatively affect reproductive, central nervous, or the immune system. In this study, the potential mechanism of POPs induced T2DM was investigated by quantitative proteomics. Five general POPs mixtures, p,p’‐DDT, heptachlor, β‐HCH, hexachlorobenzene and chlorodane were administered to zebrafish for 3 months. Proteomic analysis revealed upregulation of protein Pentaxin in zebrafish. Pentaxin is homologous to C‐reactive protein (CRP) in human, which is widely recognized as an independent risk factor for type 2 diabetes. This finding showed that POPs might be a diabetes inducer. Thus, this study increased the understanding of the relationship between POPs and T2DM in biological and proteomics aspects.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Activity of Group 2 Innate Lymphoid Cells is Associated with Chronic Inflammation and Dysregulated Metabolic Homoeostasis in Type 2 Diabetic Nephropathy.

The metabolic syndrome (MS) is an independent risk factor for type 2 diabetic nephropathy and accompanied by subclinical inflammation which involves immune-deriving factors. Emerging studies indicate that group 2 innate lymphoid cells (ILC2s) can regulate adipose metabolism, but much less is known about the activity of ILC2s in metabolic imbalance in obesity and diabetes. This study explored the effect of ILC2s-related molecules on the occurrence of MS in type 2 diabetic nephropathy. Thirty patients with type 2 diabetic nephropathy were included in the study; the mRNA expression of ILC2s-associated molecules from peripheral blood mononuclear cell and the correlation of the ILC2s activity and the MS-related indicators were analysed. The results indicated that the waist circumference, fasting blood glucose, systolic blood pressure, diastolic blood pressure and triglyceride in patients with simple diabetes and diabetic nephropathy were increased, and the incidence of MS was 46.67% and 86.67%, respectively. The ILC2s-associated factors RORα, T1/ST2 and IL-5/IL-13 mRNA were increased in diabetic nephropathy. There was a positive correlation between the expression level of IL-13 or T1/ST2 mRNA and some MS indexes. In addition, the levels of plasma sTNFR, eotaxin-2 and I-309 were also increased in patients with type 2 diabetic nephropathy. It suggested that the patients with type 2 diabetic nephropathy were more likely to have multiple components of MS than those with simple type 2 diabetes mellitus, and enhanced ILC2s activity might be involved in the formation of MS in diabetic nephropathy via influencing blood pressure and lipid metabolism.

Proceedings of the Andalas International Public Health Conference 2017

Background : Recent evidence family history of diabetes is an independent risk factor for type 2 Diabetes Mellitus. Therefore, current prevention of this group is necessary patient education that can changes healthy behavior through the formation of intention and awareness of those risks. Some interventions hypothesized can improve risk perception in order to intention to change behavior. Objective: To determine the difference of risk perception after patient education using genogram simulation and paper-based diabetes risk calculator. The design study was a non-randomized controlled trial. Subjects were identified with restriction criteria: Patient with a family history of type 2 Diabetes Mellitus, 19-50 years old, and had no evidence of Diabetes. The subjects were 35 patients; divided into control group and 2 intervention groups; they are (1) education using genogram simulation and (2) education using paper-based diabetes risk calculator. Risk perception identified by validated risk perception of developing diabetes questionnaire. Data were analyzed by Kruskall Wallis test continued by Mann Whitney U test with the level of confidence 95%. Results: There are significant differences of Risk perception after intervention groups with control, after education used genogram simulation (p=0,001) and also after education used paper-based diabetes risk calculator (p=0,039), but there was no difference in risk perception between intervention groups (p=0,223) Conclusions: There are significant differences in risk perception between the control group and interventions group, education used sgenogramimulation and also education used diabetes risk calculators Acknowledgements: Our gratitude is addressed to all colleagues and patients, for their assistance in accomplishing this research

Comparison of type 2 diabetes mellitus incidence in different phases of hepatitis B virus infection: A meta‐analysis

Because whether hepatitis B virus infection increases the risk of type 2 diabetes mellitus has been a controversial topic, pair-wise and network meta-analyses of published literature were carried out to accurately evaluate the association between different phases of hepatitis B virus infection and the risk of type 2 diabetes mellitus. A comprehensive literature retrieval was conducted from the PubMed, Embase, Cochrane Library and Chinese Database to identify epidemiological studies on the association between hepatitis B virus infection and the risk of type 2 diabetes mellitus that were published from 1999 to 2015. A pair-wise meta-analysis of direct evidence was performed to estimate the pooled odds ratios and 95% confidence intervals. A network meta-analysis was conducted, including the construction of a network plot, inconsistency plot, predictive interval plot, comparison-adjusted funnel plot and rank diagram, to graphically link the direct and indirect comparisons between different hepatitis B virus infective phases. Eighteen publications (n=113639) describing 32 studies were included in this meta-analysis. In the pair-wise meta-analysis, the pooled odds ratio for type 2 diabetes mellitus in chronic hepatitis B cirrhosis patients was 1.76 (95% confidence interval: 1.44-2.14) when compared with non-cirrhotic chronic hepatitis B patients. In the network meta-analysis, six comparisons of four hepatitis B virus infectious states indicated the following descending order for the risk of type 2 diabetes mellitus: hepatitis B cirrhosis patients, non-cirrhotic chronic hepatitis B patients, hepatitis B virus carriers and non-hepatitis B virus controls. This study suggests that hepatitis B virus infection is not an independent risk factor for type 2 diabetes mellitus, but the development of cirrhosis may increase the incidence of type 2 diabetes mellitus cirrhosis.

Potential Predictive Role of Lipid Peroxidation Markers for Type 2 Diabetes in the Adult Tunisian Population

We evaluated the potential clinical relevance of malondialdehyde (MDA) and autoantibodies to copper oxidized low-density lipoprotein (CuOx-LDL) in type 2 diabetes occurrence. This cross-sectional study enrolled 69 normoglycemic subjects, 18 prediabetic patients and 108 type 2 diabetes patients. MDA concentration was assessed spectrophotometrically. Plasma IgG, IgA and IgM levels to CuOx-LDL were determined by ELISA. Plasma MDA levels were considerably higher in obese, prediabetic and type 2 diabetes subjects compared to controls. In multiple linear regression analysis, both MDA and IgA to CuOx-LDL were significantly associated with glucose metabolism markers (p<0.05). Multiple logistic regression analyses showed that high plasma MDA and IgA to CuOx-LDL were independent risk factors for type 2 diabetes (OR 1.196, 95% CI: 1.058 to 1.353; p=0.004; OR 1.626, 95% CI: 1.066 to 2.481; p=0.024; respectively). Importantly, elevated IgA to CuOx-LDL predicted incident diabetes in patients with prediabetes (OR 2.321, 95% CI:1.063 to 5.066; p=0.035). From stratified analyses by body mass index (BMI), both MDA and IgA to CuOx-LDL remained independent predictors of type 2 diabetes occurrence in non-obese subjects (p<0.05). More interesting, elevated IgA to CuOx-LDL levels could be predictors of type 2 diabetes in obese prediabetic subjects (p=0.044). Conversely, neither IgG nor IgM to CuOx-LDL was associated with glucose metabolism markers, obesity or type 2 diabetes. Plasma MDA and IgA to CuOx-LDL were significantly associated with blood markers of glucose metabolism. High levels of MDA and IgA to CuOx-LDL could independently predict type 2 diabetes development in normoglycemia and prediabetic subjects.