Independent Risk Factor For Type 2 Diabetes Mellitus Research Articles

Relationship between Apolipoprotein E gene polymorphism and mild cognitive impairment among the patients with type 2 diabetes mellitus

Objective To investigate the relationship between apolipoprotein E(Apo E) gene poly-morphism and mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM), and e-valuate the correlative risk factors. Method 40 cases of type 2 diabetes with MCI and 80 cases of type 2 diabetes without MCI were enrolled in this study. The polymorphism of the Apo E gene was detected by PCR-restriction fragment length polymorphism(PCR-RFLP). According to the clinical data such as course of disease, plasma glucose, plasma fat and body mass index (BMI), the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression. Results The frequency of Apo E e_4 allele in the group of type 2 diabetes with MCI was higher than that without MCI ( 25.0% vs 10. 0% ), and the difference had statistical significance( P < 0. 01 ). The indexes of the statistical significant difference be-twcen the two groups were age, course of disease, postprandial blood glucose ( P2BG), HBA1C, BMI,family history of T2DM, hypertension, diabetic retinopathy, diabetic peripheral neuropathy, Apo E gene. The independent risk factors included diabetic retinopathy ( OR = 3. 452, P < 0. 05 ), diabetic peripheral neuropathy( OR = 3. 252, P <0. 05), Ape E gene( OR = 2. 441, P < 0.01 ), HBA1C ( OR = 1. 372, P <0.05), P2BG(OR = 1. 194, P <0.05), age(OR = 1. 194, P <0.01) and course of disease(OR =1. 142, P <0. 05). Conclusion Apo E e_4 allele has significant relationship with T2DM and MCI. The age, course of disease, control of plasma glucose, and microvascular complication of diabetes have relation-ship with the cognitive function. Key words: Apolipoproteins/GE; Diabetes mellitus,type 2/GF,/CO; Cognition disorders/GE/CO

Relationship between fatty liver and glucose metabolism: A cross-sectional study in 571 obese children

Background and aimsEarly onset type 2 diabetes mellitus (T2DM) is associated with obesity, insulin resistance and impaired beta-cell function. Non-alcoholic fatty liver disease (NAFLD) may be an independent risk factor for T2DM. We investigated the relationship between NAFLD and glucose metabolism in a large sample of obese children. Methods and ResultsA total of 571 obese children (57% males and 43% females) aged 8–18 years were consecutively studied at a tertiary care centre specialised in paediatric obesity. Liver ultrasonography was used to diagnose NAFLD after exclusion of hepatitis B and C and alcohol consumption. Oral-glucose tolerance testing (OGTT) was performed; insulin sensitivity was evaluated by using the insulin sensitivity index (ISI) and beta-cell function by using the ratio between the incremental areas under the curve (AUC) of insulin and glucose (incAUCins/incAUCglu). A total of 41% of the obese children had NAFLD. Impaired glucose tolerance or T2DM was present in 25% of the children with NAFLD versus 8% of those without it (p<0.001). Children with NAFLD had higher body mass index (BMI), fasting glucose, 120-min OGTT glucose, incAUCins/incAUCglu and lower ISI as compared with children without NAFLD (p≤0.002). At bootstrapped multivariable median regression analysis controlling for gender, age, pubertal status and BMI, NAFLD was an independent predictor of 120-min OGTT glucose and ISI, but not of incAUCins/incAUCglu. Similar findings were obtained using continuous liver steatosis as the predictor, instead of dichotomous NAFLD. ConclusionNAFLD was present in 41% of our obese children and was associated with higher insulin resistance, but not with impaired beta-cell function.

Adiponectin as a therapeutic target for obesity‐related metabolic and cardiovascular disorders

AbstractObesity is the major risk factor for the metabolic syndrome, which encompasses a cluster of inter‐related metabolic risk factors for type 2 diabetes mellitus (T2DM), atherosclerosis, and cardiovascular diseases. Adiponectin, a major adipokine secreted from adipocytes, plays an important role in obesity‐related metabolic and cardiovascular diseases. Longitudinal studies from different ethnic groups have identified low levels of plasma adiponectin (hypoadiponectinemia) to be an independent risk factor for T2DM, hypertension, and coronary artery diseases. On the other hand, results from various animal models have demonstrated the role of adiponectin as an insulin‐sensitizer with potent anti‐diabetic, anti‐atherogenic, anti‐inflammatory, and cardio‐protective activities. Therefore, upregulation of endogenous adiponectin production by pharmacological and/or dietary interventions might have multiple beneficial effects on obesity‐related disorders. A number of pharmacological agents that increase adiponectin production have recently been identified. Among them, the anti‐diabetic actions of the PPARγ agonists, thiazolidinediones (TZDs), are mediated, at least in part, by induction of adiponectin expression. Here, we summarize the recent progress on clinical and pharmacological studies of adiponectin, and discuss the utility of adiponectin as a target to develop novel therapies for treatment and prevention of obesity‐related metabolic and cardiovascular diseases. Drug Dev. Res. 67:677–686, 2006. © 2006 Wiley‐Liss, Inc.