Indices Of Glucose Metabolism Research Articles

Correlation between gestational diabetes mellitus and postpartum cardiovascular metabolic indicators and inflammatory factors: a cohort study of Chinese population

ObjectiveThis study aimed to analyze the correlation between gestational diabetes mellitus and postpartum metabolic indicators and inflammatory factors, and explore the role of inflammatory factors, so as to provide evidence for the early prevention of postpartum CVD risk in gestational diabetes mellitus.MethodsThis prospective study was based on the pregnant women cohort study established in Peking University International Hospital from December 2017 to March 2019. A total of 120 women were enrolled sequentially, including 60 cases of gestational diabetes mellitus (GDM group) and 60 cases of non-gestational diabetes mellitus (non-GDM group) after 4-7 years. The general information, inflammatory factors and metabolic indicators of the women were collected and analyzed.Results(1)The TyG and siMS levels in the GDM group were higher than those in the non-GDM group (p<0.05, respectively). The interleukin-6(IL-6) levels in the GDM group were higher than those in the non-GDM group and the difference was statistically significant (p<0.05). (2) The results of linear regression analysis showed that GDM was associated with postpartum GLU0min (β=0.94, 95%CI: 0.27-1.60, p<0.05), GLU120min (β=2.76, 95%CI: 1.57-3.94, p<0.05) and HbA1c (β=0.49, 95%CI: 0.27-1.60, p<0.05). At the same time, GDM was significantly correlated with postpartum metabolic indicators triglyceride-glucose (TyG) index (β=0.31, 95%CI: 0.01-0.61, p<0.05) and siMS score (β=0.45, 95%CI: 0.03-0.88, p<0.05).The results of linear regression analysis showed that GDM was significantly correlated with IL-6 (β=0.91, 95%CI: 0.02-1.79, p<0.05). (3) Logistic regression analysis showed that GDM was an independent risk factor for postpartum abnormal metabolism (OR=10.62, 95%CI: 1.66-68.17, p<0.05), and an independent risk factor for postpartum high low-density lipoprotein cholesterolemia (OR=3.38, 95%CI: 1.01-11.56, p<0.05). (4) The IL-6 had a mediating effect in the association between GDM and postpartum TyG and siMS, with the mediating effect sizes being 20.59% and 30.77%, respectively.ConclusionThis study revealed that GDM history can lead to abnormal glucose and lipid metabolism indexes in postpartum women, affect the levels of postpartum CVD-related metabolic indicators. Meanwhile, IL-6 shows a mediating role, providing important clinical evidence for the prevention and control of CVD in such high-risk populations and the improvement of cardiovascular health.

Correlation between glucose metabolism and body mass index in tumor lesions of patients with lung cancer

ObjectiveLung cancer, along with various other cancers, is characterized by increased glucose metabolism. The maximum standardized uptake value (SUVmax), derived from positron emission tomography-computed tomography (PET-CT), serves as an indicator of glucose metabolic activity in tumor lesions. This study aimed to evaluate the correlation between body mass index (BMI) and SUVmax in individuals with lung cancer.MethodsThis study included 41 patients with lung cancer, who were divided into two groups: Group 1 (n = 21), with a BMI greater than 22.4, and Group 2 (n = 20), with a BMI less than 22.4. All participants underwent 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) imaging. The SUVmax was calculated by manually delineating the regions of interest. A t-test was performed to assess whether the differences in SUVmax between the two groups were statistically significant.ResultsThe mean SUVmax for Group 1 was 11.20 ± 5.45, while for Group 2 it was 10.65 ± 5.96. Although the mean SUVmax was higher in Group 1 compared to Group 2, the difference between the groups was not statistically significant (P = 0.757).ConclusionThe findings indicate a non-significant difference in glucose metabolism in lung cancer lesions between patients with different BMI levels. These results offer valuable insights into the metabolic characteristics of lung cancer and contribute to a deeper understanding of its pathophysiology.

The Effect of a Multidisciplinary Lifestyle Intervention Program on Apelin-12, Vaspin and Resistin Concentrations in Children and Adolescents with Overweight and Obesity.

Background: Obesity in childhood and adolescence has reached epidemic proportions in recent decades. Methods: In the present study, we determined the concentrations of apelin-12, vaspin and resistin in 106 children and adolescents with overweight or obesity before and after the implementation of a multidisciplinary, personalized lifestyle intervention program of diet, sleep and exercise for 1 year. All subjects attended our Center for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence. Results: Following the lifestyle intervention, there were significant decreases in BMI (p < 0.01), apelin-12 (p < 0.05) and resistin (p < 0.01) concentrations, and an increase in vaspin (p < 0.01) concentration. Glucose was the best positive predictor of apelin-12 (b = 0.236, p < 0.05), and osteopontin was the best negative predictor of changes in apelin-12 (b = -0.299, p < 0.05). Vaspin correlated positively with adiponectin (b = 0.29, p < 0.05), while vitamin D (b = 0.621, p < 0.05) was the best positive predictor of vaspin. BMI z score (b = -0.794, p < 0.05), HDL (b = -0.284, p < 0.05) and HbA1C (b = -0.262, p < 0.05) were the best negative predictors of changes in vaspin. BMI z score was the best positive predictor of resistin (b = 0.437, p < 0.05). Conclusions: These findings suggest that apelin-12, vaspin and resistin correlate with indices of obesity, glucose, lipids and bone metabolism, while interaction with other proteins, such as osteopontin and adiponectin, was also noted. Therefore, apelin-12, vaspin and resistin may be used as biomarkers in children and adolescents with overweight and obesity.

Positron emission tomography neuroimaging of [18F]fluorodeoxyglucose uptake and related behavior in the Pink1-/- rat model of Parkinson disease.

Parkinson disease (PD) is a neurodegenerative condition affecting multiple sensorimotor and cognitive systems. The Pink1-/- rat model exhibits vocal, cognitive, and limb use deficits seen in idiopathic PD. We sought to measure glucose metabolism in brain regions in Pink1-/- and wild type (WT) rats, and to associate these to measures of ultrasonic vocalization, cognition, and limb use behavior. Pink1-/- (n = 12) and WT (n = 14) rats were imaged by [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in a repeated measures design at approximately 10 months of age and 6 weeks later. Relative regional glucose metabolism was indexed by whole brain normalized FDG uptake, which was calculated for 18 regions identified a priori for comparison. Behavioral measures included tests of communication via ultrasonic vocalization, cognition with 5-Choice Serial Reaction Time Test (5-CSRTT), and limb use with Cylinder Test and Challenge Beam. Relative glucose metabolism was significantly different in Pink1-/- rats in prelimbic area, striatum, nucleus ambiguus, globus pallidus, and posterior parietal association cortex compared to WT controls. For behavioral measures, Pink1-/- rats demonstrated quieter vocalizations with a restricted frequency range, and they showed increased number of foot-faults and hindlimb steps (shuffling) in limb motor tests. Significant behavior vs. brain correlations included associations of ultrasonic vocalization parameters with glucose metabolism indices in locus coeruleus and substantia nigra. FDG PET reveals abnormalities in relative regional brain glucose metabolism in Pink1-/- rats in brain regions that are important to cognition, vocalization, and limb motor control that are also impacted by Parkinson disease. This method may be useful for mechanistic studies of behavioral deficits and therapeutic interventions in translational studies in the Pink1-/- PD model.

Swimming exercise regulates indices of skeletal muscle glucose metabolism and attenuates cardiac inflammatory cytokines activity via IL-6/TNF-α pathway in streptozotocin-induced diabetic rats

Diabetes mellitus (DM) manifests with impaired glucose metabolism that affects the musculoskeletal and cardiovascular systems. This study investigated the effects of swimming exercise on some indices of muscle glucose metabolism and cardiac inflammatory markers in diabetic rats induced with streptozotocin. Wistar rats of both sexes (150–200 g) were assigned into five groups of seven (7) rats. Group 1: Control (CON), Group 2: Diabetes only (DM), Group 3: Exercise only (EX), Group 4: Diabetes + Exercise (DM + EX), Group 5: Diabetes + Insulin (DM + IN). Type 1 DM was induced via intraperitoneal injection of streptozotocin (60 mg/kg). Insulin (6 IU/g) was administered (IP) to animals in group 5. Swimming exercise test was done for 27 days after which animals were euthanized. Blood samples were collected while hamstring muscles and heart were harvested and homogenized to assess biochemical parameters. The body weight, serum insulin level, muscle glucose metabolic indices (glycogen, Glut-4, CK-MB), and cardiac troponin-T were significantly (P < 0.05) decreased. In contrast, the random blood glucose, cardiac TNF-α, and IL-6 levels were increased (P < 0.05) in diabetic rats when compared with the control group. Swimming exercise regimen significantly (P < 0.05) reversed these anomalies by reducing blood glucose and cardiac inflammatory cytokines (TNF-α and IL-6) levels, improving serum insulin, muscle glycogen, and GLUT-4 expression in diabetic rats when compared to the DM group. The cardiac inflammatory cytokine levels in DM + EX were comparable to the DM + IN group. In conclusion, swimming exercise improves muscle glucose metabolism and protects the heart against cardiac inflammation in diabetic conditions.

Oxidative stress and inflammation on metabolic abnormalities and renal involvement in prediabetic subjects across Europe

BackgroundStudying the mechanisms involved in the transition from prediabetes to diabetes and its associated complications, such as kidney disease, is a growing challenge. This study focuses on identifying valuable biomarkers for the early detection of kidney damage, evaluating molecules associated with oxidative stress and inflammation in prediabetic individuals across Europe. MethodsIn plasma samples from individuals with prediabetes included in the ePREDICE study, we determined molecules related to oxidative stress (advance oxidative protein products-AOPP) and inflammatory biomarkers (C-reactive protein – CRP; Interleukin 6 – IL-6), and correlated them with anthropometric and biochemical data, assessing their potential for the early diagnosis of renal involvement. ResultsAmong the 967 people with prediabetes, 94 presented some sign of renal impairment such as albuminuria, hyperfiltration or hypofiltration. Significant variations were identified between oxidative stress and inflammatory biomarkers (upper and lower quartiles of AOPP, CRP and IL6), and parameters associated with blood pressure, glucose metabolism, lipid profile, and fatty liver index. In particular, both types of biomarkers were associated with components of the metabolic syndrome. There were significant associations between AOPP and CRP, and the presence of albuminuria, but not with renal function. Overall, CRP was a better biomarker than IL-6 for most of the parameters studied. ConclusionThese results highlight the important associations of oxidative stress and inflammation with metabolic abnormalities linked to the prediabetic state and its complications such as fatty liver and renal involvement. Although these results need to be confirmed, our study suggests that AOPP and CRP could be simple biomarkers of interest in predicting the risk of loss of renal function in people with prediabetes.

Gut microbiota and metabolomic profile changes play critical roles in tacrolimus-induced diabetes in rats.

Hyperglycemia is one of the adverse effects of tacrolimus (TAC), but the underlying mechanism is not fully identified. We used multi-omics analysis to evaluate the changes in the gut microbiota and metabolic profile of rats with TAC-induced diabetes. To establish a diabetic animal model, Sprague Dawley rats were divided randomly into two groups. Those in the TAC group received intraperitoneal injections of TAC (3 mg/kg) for 8 weeks, and those in the CON group served as the control. 16S rRNA sequencing was used to analyze fecal microbiota. The metabolites of the two groups were detected and analyzed by nontargeted and targeted metabolomics, including amino acids (AAs), bile acids (BAs), and short-chain fatty acids (SCFAs). The rats treated with TAC exhibited hyperglycemia as well as changes in the gut microbiota and metabolites. Specifically, their gut microbiota had significantly higher abundances of Escherichia-Shigella, Enterococcus, and Allobaculum, and significantly lower abundances of Ruminococcus, Akkermansia, and Roseburia. In addition, they had significantly reduced serum levels of AAs including asparagine, aspartic acid, glutamic acid, and methionine. With respect to BAs, they had significantly higher serum levels of taurocholic acid (TCA), and glycochenodeoxycholic acid (GCDCA), but significantly lower levels of taurodeoxycholic acid (TDCA) and tauroursodeoxycholic acid (TUDCA). There were no differences in the levels of SCFAs between the two groups. Correlations existed among glucose metabolism indexes (fasting blood glucose and fasting insulin), gut microbiota (Ruminococcus and Akkermansia), and metabolites (glutamic acid, hydroxyproline, GCDCA, TDCA, and TUDCA). Both AAs and BAs may play crucial roles as signaling molecules in the regulation of TAC-induced diabetes.

Effects of vitamin D supplementation on diabetic foot ulcer healing: a meta-analysis.

To systematically review the effect of vitamin D supplementation on diabetic foot ulcer (DFU) healing. The PubMed, Web of Science, Science direct, Ebsco host, CNKI, WanFang, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on the impact of vitamin D supplementation on DFUs from inception to 19 November 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. A total of seven studies involving 580 patients were included. The results of meta-analysis showed that compared with control group, the wound healing efficiency rate (RR = 1.42, 95%CI 1.03 to 1.95, P= 0.03) and wound reduction rate (MD = 13.11, 95%CI 4.65 to 21.56, P < 0.01) of the experimental group were higher; the change values of the wound area (MD = -3.29, 95%CI -4.89 to 1.70, P < 0.01) and 25 (OH) D (MD = 9.63, 95%CI 6.96 to 12.31, P < 0.01) were larger. Supplementation of vitamin D on DFU patients can improve glucose metabolism and insulin indexes: hemoglobin A1c (MD = -0.44, 95%CI -0.62 to -0.26, P < 0.01), fasting insulin (MD = -3.75, 95%CI -5.83 to -1.67, P < 0.01), HOMA - β (MD = -5.14, 95%CI -8.74 to -1.54, P < 0.01), and quantitative insulin sensitivity check index (MD = 0.02, 95%CI 0.01 to 0.02, P < 0.01). It can also improve inflammation and oxidative stress markers: high sensitivity C-reactive protein (MD = -0.83, 95%CI -1.06 to -0.59, P < 0.01), erythrocyte sedimentation rate (MD = -15.74, 95%CI -21.78 to -9.71, P<0.01), nitric oxide (MD = 1.81, 95%CI 0.07 to 3.55, P= 0.04), and malondialdehyde (MD = -0.43, 95%CI -0.61 to -0.24, P<0.01). There was no statistically significant difference in changes of fasting plasma glucose, homeostasis model of assessment-insulin resistance, total antioxidant capacity, glutathione, very low density lipoprotein cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol (P>0.05). The current evidence suggests that vitamin D supplementation can significantly promote DFU healing by lowering blood sugar and alleviating inflammation and oxidative stress. Key messages What is already known on this topic Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, with high morbidity, mortality and resource utilization. Vitamin D has the effect of lowering blood sugar, improving insulin sensitivity, and increasing anti-inflammatory response. Clinical research on vitamin D supplementation for the treatment of DFU is increasing, but due to the lack of combing and integration, the actual efficacy of vitamin D in patients is unclear. What this study adds This meta-analysis has shown that vitamin D supplementation can significantly promote DFU healing by lowering blood glucose and alleviating inflammation and oxidative stress. How this study might affect research, practice or policy This study preliminarily found the effectiveness of vitamin D supplementation on the healing of DFU, which can provide a reference for the treatment of DFU by medical staff.

Effects of Zishen Yutai pills combined with metformin on women with polycystic ovary syndrome undergoing in vitro fertilization.

In this study, we analyzed the clinical efficacy of Zishen Yutai pills (ZSYTP) combined with metformin hydrochloride on infertile women diagnosed with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Patients were assigned into 3 groups: the ZSYTP group (n = 50), the metformin group (n = 50), and the combination group (ZSYTP combined with metformin hydrochloride, n = 50), based on their respective and the indicated treatments before undergoing IVF-ET. Then, their glucose metabolism indices, sex hormone indices, traditional Chinese medicine (TCM) syndrome scores, and outcomes of IVF-ET were compared. Baseline characteristics were not significantly different between the 2 groups. After treatment, various parameters such as body mass index (BMI), fasting plasma glucose (FPG), fasting insulin (FIN), homeostatic model assessment of insulin resistance (HOMA-IR), luteinizing hormone (LH), estradiol (E2), follicle-stimulating hormone (FSH), testosterone (T) levels, and TCM syndrome scores were found to be reduced compared to pretreatment levels in both groups. Moreover, the improvement observed in the treatment group exceeded that of the control group. Specifically, the observation group displayed significantly lower gonadotropin (Gn) dosage and duration, as well as a reduced abortion rate compared to the control group. Furthermore, the observation group had higher numbers of obtained eggs, high-quality embryos, eggs obtained through IVF-ET, average transferred embryos, clinical pregnancy rate, and embryo implantation rate compared to the control group. Pretreatment with ZSYTP combined with metformin before IVF-ET in PCOS patients improves the outcome of IVF-ET.

Explaining recovery from coma with multimodal neuroimaging

The aim of this prospective, observational cohort study was to investigate and assess diverse neuroimaging biomarkers to predict patients’ neurological recovery after coma. 32 patients (18–76 years, M = 44.8, SD = 17.7) with disorders of consciousness participated in the study. Multimodal neuroimaging data acquired during the patient’s hospitalization were used to derive cortical glucose metabolism (18F-fluorodeoxyglucose positron emission tomography/computed tomography), and structural (diffusion-weighted imaging) and functional connectivity (resting-state functional MRI) indices. The recovery outcome was defined as a continuous composite score constructed from a multivariate neurobehavioral recovery assessment administered upon the discharge from the hospital. Fractional anisotropy-based white matter integrity in the anterior forebrain mesocircuit (r = 0.72, p < .001, 95% CI: 0.87, 0.45), and the functional connectivity between the antagonistic default mode and dorsal attention resting-state networks (r = − 0.74, p < 0.001, 95% CI: − 0.46, − 0.88) strongly correlated with the recovery outcome. The association between the posterior glucose metabolism and the recovery outcome was moderate (r = 0.38, p = 0.040, 95% CI: 0.66, 0.02). Structural (adjusted R2 = 0.84, p = 0.003) or functional connectivity biomarker (adjusted R2 = 0.85, p = 0.001), but not their combination, significantly improved the model fit to predict the recovery compared solely to bedside neurobehavioral evaluation (adjusted R2 = 0.75). The present study elucidates an important role of specific MRI-derived structural and functional connectivity biomarkers in diagnosis and prognosis of recovery after coma and has implications for clinical care of patients with severe brain injury.

Exploring the active components and potential mechanisms of Alpiniae oxyphyllae Fructus in treating diabetes mellitus with depression by UPLC-Q-Exactive Orbitrap/MS, network pharmacology and molecular docking.

The growing incidence of diabetes mellitus (DM) and depression is a global public health issue. Alpiniae oxyphyllae Fructus (AOF) is a kind of medicinal and edible plant which be found with anti-diabetic property, and could improve depression-like symptoms. This study aimed to screen active targets and potential mechanisms of AOF in treating DM with depression. Injection of streptozotocin (STZ) and exposure to chronic unpredictable mild stress (CUMS) for 4 weeks were used to conduct the DM with depression mice model. Behavioral tests, indexes of glucose metabolism, monoamine neurotransmitters, inflammatory cytokine and oxidative stress were measured. Histopathological change of hippocampus tissue was observing by HE and Nissl staining. UPLC-Q-Exactive Orbitrap/MS, network pharmacology and molecular docking were used to explore the chemical components and mechanisms of AOF on the DM with depression. AOF showed a reversed effect on body weight in DM with depression mice. Glucose metabolism and insulin resistance could be improved by treatment of AOF. In addition, AOF could alleviate depression-like behaviors based on the results of behavior tests and monoamine neurotransmitters. AOF also attenuated STZ-CUMS induced neuron injury in hippocampus. Next, a total of 61 chemical components were identified in the UPLC-Q-Exactive Orbitrap/MS analysis of the extract of AOF. Network pharmacology analysis suggested that 12 active components and 227 targets were screened from AOF, and 1802 target genes were screened from DM with depression, finally 126 intersection target genes were obtained. Drug-disease targets network was constructed and implied that the top five components with a higher degree value includes quercetin, nootkatone, baicalein, (-)-epicatechin and nootkatol. Protein-protein interaction (PPI) network showed that MAPK1, FOS, AKT1, IL6 and TP53 may be the core intersection targets. The mechanism of the effect of AOF on DM with depression was analyzed through gene ontology (GO), and kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis, mainly involved in AGE/RAGE, PI3K/AKT, and MAPK signaling pathways. The results of molecular docking indicated that quercetin, nootkatone, baicalein, (-)-epicatechin and nootkatol all had good binding to the core intersection targets. Overall, our experimental researches have demonstrated that AOF could exert the dual effects of anti-diabetic and anti-depression on DM with depression mice, through multi-targets and multi-pathways.

Unveiling the link between ACR TI-RADS grading and Bethesda score of thyroid nodules in diabetic patients: A comprehensive analysis.

This study aimed to explores the factors influencing thyroid nodules (TNs) in individuals with type 2 diabetes mellitus (T2DM) and evaluates the consistency between different American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) grades and Bethesda scores. Total of 642 T2DM patients were divided into TN group (245) and control group (397) based on the presence or absence of TNs. TN patients were further categorized into ACR TI-RADS classification (TR) 1 to 4 and TR5 subgroups. Diabetes-related clinical and biochemical parameters were collected, and differences were analyzed using univariate analysis. Logistic regression analysis was utilized to pinpoint independent influencing factors for TN occurrence and different TN classifications. Consequently, age, body mass index (BMI), fasting plasma glucose level (FBGL), low density lipoprotein cholesterol (LDL-C), diabetic progression, and family history of TNs emerged as independent risk factors for TN development in T2DM patients. Additionally, glycosylated hemoglobin (HbA1c), nodule diameter, and family history of TNs were identified as independent risk factors for TR5 TN development in T2DM patients. All TR1 to 2 nodules had a Bethesda score of 2 and all showed benign pathological findings. In 97.10% of cases (67/69), nodules classified as TR3 exhibited a Bethesda score of 2, with all pathological results indicating benign findings, aligning with the Bethesda score. In addition, the concordance between TR4 nodules and Bethesda score was only 78.57% (88/112). In conclusion, TNs and their malignancy in T2DM patients are significantly linked to blood glucose and lipid metabolism indexes. TR3 classification in T2DM patients poses a low malignancy risk, suggesting caution when conducting fine needle aspiration cytology (FNAC) testing.

Efficacy of powder of ginsengporia and atractylodis macrocephalae combined with aerobic exercise in the treatment of obese T2DM: A randomized controlled clinical trial

BackgroundTo explore the efficacy of powder of ginsengporia and atractylodis macrocephalae combined with aerobic exercise in the treatment of obese T2DM and its influence on glucose and lipid metabolism indices. ResultsBoth groups of patients were given metformin drug treatment. The control group was given aerobic exercise intervention, and the observation group was given ginsengporia and atractylodis macrocephalae on the basis of the control group. The total effective rate of the observation group (95.74%) was higher than that of the control group (82.98%) (P < 0.05). After treatment, the main symptoms of the observation group were less (P < 0.05), such as thirst and lack of desire to drink, fatigue, loss of appetite, limb numbness and tingling, sticky stool, scanty dark urine, and lower total score. FPG, 2hPG, and HbA1c were lower (P < 0.05), FINS, HOMA-IR, and HOMA-β were higher (P < 0.05), TG, TC, and LDL-C were lower, and HDL-C levels were higher in the observation group (P < 0.05). After treatment, Nesfatin-1 and adiponectin were lower, visfatin and leptin were higher (P < 0.05), and GIP and GLP-1 levels were higher in the observation group (P < 0.05). No significant difference was found in the incidence of adverse reactions between the two groups (P > 0.05). ConclusionsPowder of ginsengporia and atractylodis macrocephalae combined with aerobic exercise is effective in treating obese T2DM, which can alleviate clinical symptoms and the disorder of glucose and lipid metabolism, and improve the islet function and gastrointestinal function.How to cite: Liu G, Kanti Das S. Efficacy of powder of ginsengporia and atractylodis macrocephalae combined with aerobic exercise in the treatment of obese T2DM: A randomized controlled clinical trial. Electron J Biotechnol 2024;71. https://doi.org/10.1016/j.ejbt.2024.04.006.

#715 Adiponectin / leptin ratio as an index to determine the risk of metabolic and rejection complications in patients after kidney transplantation

Abstract Background and Aims Adipose tissue, as an endocrine and paracrine organ, produces several hormones that are involved in the regulation of metabolic and inflammatory processes or immune system activity. While leptin is the main pro-inflammatory marker of adipose tissue, adiponectin is characterized by its anti-inflammatory effects. The adiponectin / leptin (A/L) ratio had been shown to correlate better with the occurrence of cardiometabolic risk factors than hormone concentrations alone. Results in the general population suggest that an A/L ratio &amp;gt; 1 can be considered normal, an A/L ratio of 0.5-1 indicates a moderate increase, and an A/L ration &amp;lt; 0.5 a high increase in cardiometabolic risk. The first aim of our study was to determine the risk of developing post-transplant diabetes mellitus (PTDM), prediabetes and other metabolic risk factors in relation to the A/L ratio in patients after kidney transplantation (KT). The second aim was to determine the risk of developing acute graft rejection in relation to the A/L ratio in patients after KT. Method A total of 104 patients were included in our prospective analysis after applying inclusion and exclusion criteria. Pre-transplantation and subsequently at 3, 6 and 12 months after KT, we recorded baseline characteristics of donors and recipients, including parameters characterizing graft function, metabolic (lipid profile, indices of glucose metabolism) and anthropometric parameters. At the same time, we examined serum adipocytokine concentrations (adiponectin, leptin) and calculated the A/L ratio. In the third month after KT, all patients underwent protocol graft biopsy and donor specific antibody (DSA) testing by Luminex method. Results We found that during the follow-up period, there was a significant increase in the A/L ratio in the control group (p = 0.0013) and, on the other hand, a significant decrease in the group who developed PTDM (p = 0.0003). Comparing the different subgroups divided on the A/L ratio one year after KT, we found that patients with an A/L &amp;lt; 0.5 were significantly longer in the dialysis program, had higher body mass index (BMI), waist circumference, worse graft function, and a higher prevalence of prediabetes and PTDM compared with those whose A/L ratio was &amp;gt; 1. Using logistic regression in multivariate analysis, we identified age at the time of KT [OR 1.0709, (p = 0.0337)], triglycerides level at 1 year after KT [OR 2.7735, (p = 0.446)] and A/L ratio &amp;lt; 0.5 [OR 3.1724, (p = 0.014)] as independent risk factors for the development of prediabetes and PTDM 1 year after KT. At the same time, after adjusting for differences in baseline donor and recipient characteristics, we identified the subgroup with an A/L ratio &amp;lt; 0.5 pre-transplant [HR 1.6126, (p = 0.0133)] and 3 months after KT [HR 1.3150, (p = 0.0172)] as an independent risk factor for the development of acute graft rejection. In the subsequent specification of the rejection episode, we found that A/L ratio &amp;lt; 0.5 pre-transplant [HR 2.2353, (p = 0.0357)] and 3 months after KT [HR 3.0954, (p = 0.0237)] is and independent risk factor for the occurrence of acute humoral rejection with DSA positivity. Conclusion In our study, we found that an A/L ratio &amp;lt; 0.5 is an independent risk factor for the development of prediabetes, PTDM 1 year after KT and acute humoral graft rejection with de novo DSA production in the third month after KT. This is the first study to investigate the correlation of the A/L ratio with the risk of developing metabolic and immunological complications in patients after KT.

Association of exposure to multiple perfluoroalkyl and polyfluoroalkyl substances and glucose metabolism in National Health and Nutrition Examination Survey 2017-2018.

To investigate the relationships between perfluoroalkyl and polyfluoroalkyl substances (PFASs) exposure and glucose metabolism indices. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 waves were used. A total of 611 participants with information on serum PFASs (perfluorononanoic acid (PFNA); perfluorooctanoic acid (PFOA); perfluoroundecanoic acid (PFUA); perfluorohexane sulfonic acid (PFHxS); perfluorooctane sulfonates acid (PFOS); perfluorodecanoic acid (PFDeA)), glucose metabolism indices (fasting plasma glucose (FPG), homeostasis model assessment for insulin resistance (HOMA-IR) and insulin) as well as selected covariates were included. We used cluster analysis to categorize the participants into three exposure subgroups and compared glucose metabolism index levels between the subgroups. Least absolute shrinkage and selection operator (LASSO), multiple linear regression analysis and Bayesian kernel machine regression (BKMR) were used to assess the effects of single and mixed PFASs exposures and glucose metabolism. The cluster analysis results revealed overlapping exposure types among people with higher PFASs exposure. As the level of PFAS exposure increased, FPG level showed an upward linear trend (p < 0.001), whereas insulin levels demonstrated a downward linear trend (p = 0.012). LASSO and multiple linear regression analysis showed that PFNA and FPG had a positive relationship (>50 years-old group: β = 0.059, p < 0.001). PFOA, PFUA, and PFHxS (≤50 years-old group: insulin β = -0.194, p < 0.001, HOMA-IR β = -0.132, p = 0.020) showed negative correlation with HOMA-IR/insulin. PFNA (>50 years-old group: insulin β = 0.191, p = 0.018, HOMA-IR β = 0.220, p = 0.013) showed positive correlation with HOMA-IR/insulin, which was essentially the same as results that obtained for the univariate exposure-response map in the BKMR model. Association of exposure to PFASs on glucose metabolism indices showed positive interactions between PFOS and PFHxS and negative interactions between PFOA and PFNA/PFOS/PFHxS. Our study provides evidence that positive and negative correlations between PFASs and FPG and HOMA-IR/insulin levels are observed, respectively. Combined effects and interactions between PFASs. Given the higher risk of glucose metabolism associated with elevated levels of PFAS, future studies are needed to explore the potential underlying mechanisms.

Dietary Betaine Improves Glucose Metabolism in Obese Mice

BackgroundObesity caused by the overconsumption of energy-dense foods high in fat and sugar has contributed to the growing prevalence of type 2 diabetes. Betaine, found in food or supplements, has been found to lower blood glucose concentrations, but its exact mechanism of action is not well understood. ObjectivesA comprehensive evaluation of the potential mechanisms by which betaine supplementation improves glucose metabolism. MethodsHyperglycemic mice were fed betaine to measure the indexes of glucose metabolism in the liver and muscle. To explore the mechanism behind the regulation of betaine on glucose metabolism, Ribonucleic Acid-Seq was used to analyze the livers of the mice. In vitro, HepG2 and C2C12 cells were treated with betaine to more comprehensively evaluate the effect of betaine on glucose metabolism. ResultsBetaine was added to the drinking water of high-fat diet-induced mice, and it was found to reduce blood glucose concentrations and liver triglyceride concentrations without affecting body weight, confirming its hypoglycemic effect. To investigate the specific mechanism underlying its hypoglycemic effect, protein-protein interaction enrichment analysis of the liver revealed key nodes associated with glucose metabolism, including cytochrome P450 family activity, insulin sensitivity, glucose homeostasis, and triglyceride concentrations. The Kyoto Encyclopedia of Genes and Genomes and gene ontogeny enrichment analyses showed significant enrichment of the Notch signaling pathway. These results provided bioinformatic evidence for specific pathways through which betaine regulates glucose metabolism. Key enzyme activities involved in glucose uptake, glycogen synthesis, and glycogenolysis pathways of the liver and muscle were measured, and improvements were observed in these pathways. ConclusionsThis study provides new insight into the mechanisms by which betaine improves glucose metabolism in the liver and muscle and supports its potential as a drug for the treatment of metabolic disorders related to glucose.

Insulin at the intersection of thermoregulation and glucose homeostasis

Mammals are protected from changes in environmental temperature by altering energetic processes that modify heat production. Insulin is the dominant stimulus of glucose uptake and metabolism, which are fundamental for thermogenic processes. The purpose of this work was to determine the interaction of ambient temperature induced changes in energy expenditure (EE) on the insulin sensitivity of glucose fluxes. Short-term and adaptive responses to thermoneutral temperature (TN, ∼28 °C) and room (laboratory) temperature (RT, ∼22 °C) were studied in mice. This range of temperature does not cause detectable changes in circulating catecholamines or shivering and postabsorptive glucose homeostasis is maintained. We tested the hypothesis that a decrease in EE that occurs with TN causes insulin resistance and that this reduction in insulin action and EE is reversed upon short term (<12h) transition to RT. Insulin-stimulated glucose disposal (Rd) and tissue-specific glucose metabolic index were assessed combining isotopic tracers with hyperinsulinemic-euglycemic clamps. EE and insulin-stimulated Rd are both decreased (∼50%) in TN-adapted vs RT-adapted mice. When RT-adapted mice are switched to TN, EE rapidly decreases and Rd is reduced by ∼50%. TN-adapted mice switched to RT exhibit a rapid increase in EE, but whole-body insulin-stimulated Rd remains at the low rates of TN-adapted mice. In contrast, whole body glycolytic flux rose with EE. This higher EE occurs without increasing glucose uptake from the blood, but rather by diverting glucose from glucose storage to glycolysis. In addition to adaptations in insulin action, ‘insulin-independent’ glucose uptake in brown fat is exquisitely sensitive to thermoregulation. These results show that insulin action adjusts to non-stressful changes in ambient temperature to contribute to the support of body temperature homeostasis without compromising glucose homeostasis.

The Evolution of the Bone Turnover Marker in Patients Following Recovery from Diabetic Ketoacidosis.

The aim of the study was to investigate whether the biomarkers for bone turnover could rapidly recover during the period of diabetic ketoacidosis (DKA). Bone turnover biomarkers, including 25-hydroxyvitamin D3, N-terminal middle molecular fragment of osteocalcin (NMID), and β-C terminal cross-linking telopeptide of type 1 collagen were evaluated using in-patient data (n=627) from Shanghai Pudong Hospital from 2018-2022. The comparison was performed between type 2 diabetes (T2D only) (n=602) and DKA (n=25), in which we checked the bone turnover markers at pre-treatment and recovery. After matching by body mass index (BMI), we found that except for 25-OH-VitD3, the age difference, indices of glucose metabolism, and bone turnover were significant between the 2 groups (p<0.05). We found only a significant restoration of NMID (p<0.001). NMID and β-CTX, when compared with T2D, showed overt distinction between recovery and T2D (p<0.05). In addition, the investigations demonstrated a substantial difference between 25-OH-VitD3 in males and NMID in females, regardless of age (p<0.05). Multilinear regression analysis revealed that 2 hours postprandial plasma C-peptide was an independent predictor of the NMID in both pre-treatment (β=0.58, p=0.003) and recovery (β=0.447, p=0.025), although sex was significant in pre-treatment (β=-0.444, p=0.020). Finally, we found that only age variation affected DKA's fasting plasma glucose level (p<0.05). The study revealed that the bone turnover of DKA is significantly different in pre-treatment and recovery; however, NMID might recover quickly if the patients received appropriate treatment. Importantly, pancreatic function plays a critical role in changing bone turnover biomarkers.

Impact of Iron Deficiency Anemia on Hemoglobin A1c Levels in Diabetic and Non-Diabetic Pregnant Women

Background: Gestational diabetes mellitus (GDM) is a well-known risk factor for pregnancy complications. While hemoglobin A1c (HbA1c) is widely used as a glycemic control indicator, it is known to exhibit falsely low or high levels during gestation. The purpose of the present study is to analyze the fluctuations in HbA1c levels throughout pregnancy in diabetic (DM) and non-DM women with or without iron deficiency anemia (A). Methods: Medical records of pregnant women who were followed up in our obstetrics clinic between 2018 and 2022 were reviewed. Demographics, gestational history, and biochemistry values including fasting glucose, HbA1c, erythrocyte and iron metabolism indexes were recorded. Statistical analysis was carried out by Mann-Whitney U and Bonferroni corrected one-way analysis of variance (ANOVA) tests. Results: 670 pregnant women (32 ± 14.2 years) were included with matched subgroups. In the non-DM and non-A group, HbA1c exhibited a significant decrease towards mid-pregnancy (5.29 vs. 5.08%, p &lt; 0.01), followed by a steep increase towards the second half of pregnancy, reaching its initial value (5.08 vs. 5.27%, p &lt; 0.01). In the non-DM and A pregnant women, HbA1c decreased from 5.25 to 5.19% (p &gt; 0.05) in first half, followed by a significant increase to 5.37% (p &lt; 0.05) in the second half of pregnancy when serum ferritin values dropped to 5.03 ± 3 µg/mL (p &lt; 0.01). As for DM and non-A group, a biphasic change in HbA1c level was also recorded, however not significant (6.05 vs. 5.81%, p &gt; 0.05). However, in the DM and A group, HbA1c levels were higher (7.09 vs. 6.01%, p &lt; 0.01), along with iron deficiency indicated by ferritin levels (4.7 ± 2.2 µg/mL, p &lt; 0.01). Conclusions: HbA1c exhibits biphasic changes throughout pregnancy, characterized by decreases towards mid-pregnancy and subsequentincreases in the third trimester. Therefore, questioning HbA1c levels is warranted, considering the changes in maternal physiology in early gestation and the increasing need for iron in later period. Furthermore, iron deficiency anaemia seems to have significant impact on the reliability of HbA1c in both the non-DM and DM pregnant women.

Pitavastatin calcium significantly improves glucose and lipid metabolism of patients with coronary atherosclerosis and reduces the occurrence of adverse cardiovascular events

Purpose: To determine the efficacy of pitavastatin calcium and atorvastatin calcium on coronary atherosclerosis (CA) and compare the influence of the two schemes on adverse cardiovascular events.&#x0D; Methods: The medical records of 198 patients with CA admitted at Affiliated Hospital of Jiangsu University, China from August 2019 to May 2011 were analyzed retrospectively. The patients were grouped into pitavastatin calcium group (n = 102) and atorvastatin calcium group (n = 96). The efficacy, incidence of adverse cardiovascular events, as well as changes in blood lipid metabolism and blood glucose metabolism indices before and after therapy were recorded and compared.&#x0D; Results: Compared with atorvastatin calcium group, pitavastatin calcium group yielded a significantly higher overall response rate (ORR, p &lt; 0.05) and presented a significantly lower total incidence of cardiovascular adverse events (p &lt; 0.05). After therapy, pitavastatin calcium group displayed significantly lower triglyceride, total cholesterol and low-density lipoprotein-cholesterol levels (p &lt; 0.05), and also presented significantly higher high-density lipoprotein-cholesterol levels (p &lt; 0.05) in contrast to atorvastatin calcium group. Furthermore, pitavastatin calcium group presented significantly lower fasting blood glucose and glycosylated hemoglobin levels than atorvastatin calcium group (p &lt; 0.05).&#x0D; Conclusion: Compared with atorvastatin calcium, pitavastatin calcium displays a better therapeutic effect in patients with CA, lowers the incidence of adverse cardiovascular events and improves glucose and lipid metabolism of patients. Future studies will focus on longer follow-up sessions to better understand the impact of the drugs on patient’s prognosis.