Glycemia Index Research Articles

Effectiveness of date seed on glycemia and advanced glycation end-products in type 2 diabetes: a randomized placebo-controlled trial

BackgroundType 2 diabetes mellitus (T2DM) is a chronic medical condition affecting more than 95% of people with diabetes. Traditionally, some medicinal plants have been considered as an effective approach in management of T2DM. This trial evaluated the effects of date seed powder (DSP) on glycemia indices and oxidative stress in T2DM patients.MethodsIn this trail, 43 patients with T2DM were randomized to two groups: either 5 g/d of the DSP or placebo for 8 weeks. Levels of glycemic indices, lipolpolysaccharide (LPS), and soluble receptor for advanced glycation end products (s-RAGE), as well as other parameters associated with oxidative stress were assessed at baseline and after 8 weeks. Independent t-test and analysis of covariance (ANCOVA) were used for between-groups comparisons at baseline and the post-intervention phase, respectively.ResultsThe results showed that supplementation with DSP significantly decreased HbA1c (−0.30 ± 0.48%), insulin (−1.70 ± 2.21 μU/ml), HOMA-IR (−1.05 ± 0.21), HOMA-B (−0.76 ± 21.21), lipopolysaccharide (LPS) (−3.68 ± 6.05 EU/mL), and pentosidine (118.99 ± 21.67 pg/mL) (P < 0.05, ANCOVA adjusted for baseline and confounding factors). On the other hand, DSP supplementation significantly increased total antioxidant capacity (TAC) (0.50 ± 0.26 mmol/L), superoxide dismutase (SOD) (0.69 ± 0.32 U/ml), and s-RAGE (240.13 ± 54.25 pg/mL) compared to the placebo group. FPG, hs-CRP, GPx, CML, and uric acid had no significant within- or between-group changes.ConclusionSupplementation of DSP could be considered an effective strategy to improve glycemic control and oxidative stress in T2DM patients (Registration ID at www.irct.ir: IRCT20150205020965N10).

The effect of bodyweight exercise on 24-h glycemic responses determined by continuous glucose monitoring in healthy inactive adults: a randomized crossover study

Vigorous intermittent exercise can improve indices of glycemia in the 24 h postexercise period in apparently healthy individuals. We examined the effect of a single session of bodyweight exercise (BWE) on glycemic responses using continuous glucose monitoring (CGM) under controlled dietary conditions. Healthy inactive adults (n = 27; 8 males, 19 females; age: 23 ± 3 years) completed 2 virtually supervised trials spaced ~ 1 week apart in a randomized, crossover manner. The trials involved an 11-min BWE protocol that consisted of 5 × 1-min bouts performed at a self-selected pace interspersed with 1-min active recovery periods or a non-exercise sitting control period (CON). Mean heart rate during the BWE protocol was 147 ± 14 beats per min (75% of age-predicted maximum). Mean 24 h glucose after BWE and CON was not different (5.0 ± 0.4 vs 5.0 ± 0.5 mM respectively; p = 0.39). There were also no differences between conditions for measures of glycemic variability or the postprandial glucose responses after ingestion of a 75 g glucose drink or lunch, dinner, and breakfast meals. This study demonstrates the feasibility of conducting a remotely supervised BWE intervention using CGM under free-living conditions. Future studies should investigate the effect of repeated sessions of BWE training or responses in people with impaired glycemic control.

Galectin-3 Mediates Vascular Dysfunction in Obesity by Regulating NADPH Oxidase 1.

Obesity is associated with increased risk of cardiovascular disease, but underlying mechanisms remain elusive. Metabolic dysfunction, especially hyperglycemia, is thought to be a major contributor, but how glucose impacts vascular function is unclear. GAL3 (galectin-3) is a sugar-binding lectin upregulated by hyperglycemia, but its role as a causative mechanism of cardiovascular disease remains poorly understood. Therefore, the objective of this study was to determine the role of GAL3 in regulating microvascular endothelial vasodilation in obesity. GAL3 was measured and found to be markedly increased in the plasma of overweight and obese patients, as well as in the microvascular endothelium of diabetic patients. To investigate causative mechanisms in cardiovascular disease, mice deficient in GAL3 were bred with obese db/db mice to generate lean, lean GAL3 knockout, obese, and obese GAL3 knockout genotypes. Endothelial cell-specific GAL3 knockout mice with novel AAV-induced obesity recapitulated whole-body knockout studies to confirm cell specificity. Deletion of GAL3 did not alter body mass, adiposity, or plasma indices of glycemia and lipidemia, but levels of plasma reactive oxygen species as assessed by plasma thiobarbituric acid reactive substances were normalized in obese GAL3 knockout mice. Obese mice exhibited profound endothelial dysfunction and hypertension, both of which were rescued by GAL3 deletion. Isolated microvascular endothelial cells from obese mice had increased expression of NOX1 (nicotinamide adenine dinucleotide phosphate oxidase 1), which we have previously shown to contribute to increased oxidative stress and endothelial dysfunction, which was normalized in microvascular endothelium from mice lacking GAL3. Cell-specific deletion confirmed that endothelial GAL3 regulates obesity-induced NOX1 overexpression and subsequent microvascular function. Furthermore, improvement of metabolic syndrome by increasing muscle mass, improving insulin signaling, or treating with metformin decreased microvascular GAL3, and thereby NOX1, expression levels. Deletion of GAL3 normalizes microvascular endothelial function in obese db/db mice, likely through a NOX1-mediated mechanism. Pathological levels of GAL3, and in turn NOX1, are amenable to improvements in metabolic status, presenting a potential therapeutic target to ameliorate pathological cardiovascular consequences of obesity.

Hyperglycemia: A determinant of cardiac autonomic dysfunction in youth with obesity across the spectrum of glycemic regulation.

To characterize the determinants of heart rate variability (HRV) in youth with obesity across the glycemia spectrum. A total of 94 adolescents, 15 ± 2.1 years (21 with normal weight, 23 with overweight-normal glucose tolerance, 26 with prediabetes and 24 with type 2 diabetes [T2D]) underwent an assessment of body composition (dual-energy x-ray absorptiometry), 2-h oral glucose tolerance test with the calculation of indices of glycemia and insulin sensitivity (IS), inflammatory markers (high-sensitivity C-reactive protein [hs-CRP] and tumour necrosis factor-α [TNF-α]), and HRV by peripheral arterial tonometry. The HRV frequency-domain index (low-frequency to high-frequency ratio [LF/HF]), an estimate of the ratio between sympathetic and parasympathetic activity, increased across the glycemic spectrum, and was highest in T2D compared with the other three groups (p = 0.004). LF/HF correlated with %body fat (r = 0.22, p = 0.04); fasting (r = 0.39, p < 0.001), 2-h (r = 0.31, p = 0.004), and area under the curve glucose (r = 0.32, p = 0.003); hs-CRP (r = 0.33, p = 0.002) and TNF-α (r = 0.38, p = 0.006). In a linear regression model, fasting glucose (β = 0.39, p = 0.003) and hs-CRP (β = 0.21, p = 0.09) contributed to the variance in Ln LF/HF independent of IS, %body fat, age, sex, race-ethnicity and Tanner stage (R2 = 0.23, p = 0.013). Youth with impaired glucose regulation have evidence of cardiac autonomic dysfunction with decreased HRV, and sympathetic overdrive (increased LF/HF). This dysfunction is mainly related to glycemia and systemic inflammation.

Effect of Glucagon-like Peptide-1 Receptor Agonists on Cardio-Metabolic Risk Factors among Obese/Overweight Individuals Treated with Antipsychotic Drug Classes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) constitute a drug class primarily developed for the treatment of subjects with type 2 diabetes, although they have also provided significant benefit for subjects with obesity without underlying diabetes. Individuals with psychotic disorders who are receiving antipsychotic treatment are a patient population at risk of developing obesity, which is linked to other metabolic disturbances. We searched PubMed and the Cochrane Library from inception to 1 December 2022, for randomized controlled trials (RCTs) enrolling obese or overweight adult subjects with an underlying psychotic disorder treated with antipsychotic drugs, randomized either to GLP-1RAs or a control. We set as the primary efficacy outcome the change in body weight and as secondary efficacy outcomes the change in body mass index (BMI) and in waist circumference, along with indices of glycemia, lipid profile, and blood pressure. We pooled data from 4 trials (2 with liraglutide and 2 with exenatide) in a total of 199 enrolled subjects. GLP-1RA treatment, compared to control, resulted in a significant decrease in body weight by 3.8 kg [mean difference (MD) = -3.80, 95% CI; -6.35 to -1.24, I2 = 64%]. In addition, GLP-1RA treatment led to a significant decrease in BMI, compared to control, of 1.04 kg/m2 (MD = -1.04, 95% CI; -1.92 to -0.17, I2 = 35%). However, no significant effect on waist circumference was shown (MD = -3.2, 95% CI; -6.47 to 0.08, I2 = 88%). A significant improvement in glycemia and lipid profiles was also demonstrated with GLP-1RAs. No subgroup difference between liraglutide and exenatide was shown, and the use of GLP-1RAs did not increase the risk for treatment discontinuation compared to the control group. Treatment with GLP-1RAs can significantly improve weight loss and other cardiometabolic risk factors in obese people taking antipsychotic medications.

Glucose Metabolism and Stress Hyperglycemia in Critically Ill Children.

Abnormalities in glucose metabolism and stress hyperglycemia (SH) are commonly seen in critically ill children. While SH may represent an adaptive stress response as a source of fuel for the body during the "fight or flight response" of critical illness, several studies have observed the association of SH with worse outcomes in different disease states. In addition to alterations in glucose metabolism and acquired insulin resistance from inflammation and organ dysfunction, specific intensive care unit (ICU) interventions can also affect glucose homeostasis and SH during critical illness. Common ICU interventions can mediate the development of SH in critical illness. The strategy of tight glucose control combined with intensive insulin therapy (TGC-IIT) has been well studied to improve outcomes in both adult and pediatric critical illness. Though early single-center studies of TGC-IIT observed benefits with better outcomes albeit with greater incidence of hypoglycemia, subsequent larger multicenter studies in both children and adults have not conclusively demonstrated benefits and have even observed harm. Several possible reasons for these contrasting results include differences in patient populations, glycemic control targets, and glucose control protocols including nutrition support, and variability in achieving these targets, measurement methods, and expertise in protocol implementation. Future studies may need to individualize management of SH in critically ill children with improved monitoring of indices of glycemia utilizing continuous sensors and closed-loop insulin administration.

Antioxidant activity and glycemic index of resistant starch from black glutinous rice

Type 2 diabetes mellitus ((T2DM) is a global public health manifested by hyperglycemia due to insulin resistance. Rice is the main staple food for the world's population but has a high glycemia index (GI) value. Therefore, this research was aimed to produce resistance starch (RS) from black glutinous rice with different methods – autoclave and annealing, freeze-thawing, and acid methanol methods. The RS content, total phenolic compound content, antioxidant activity, and estimated GI (pGI) were investigated. Results showed that the autoclave and annealing method yielded highest RS content of 27.33±8.56%, followed by freeze-thawing, 15-day acid methanol, and 30-min acid methanol methods. The RS from the autoclave and annealing method also had highest total phenolic content (61.55±1.19 mg gallic acid/g sample) and antioxidant activity by 2,2-Diphenyil-picrylhydrazyl (DPPH, IC50 of 7.40±0.24 mg/ml) and ferric reducing antioxidant power (FRAP, 75.47±0.51 mg tocopherol equivalent/g extract). Moreover, The RS from the autoclave and annealing method also had the lowest pGI (57.32±0.74). In conclusion, the autoclave and annealing process gave the highest yield of RS with the highest total phenolic content and antioxidant activity; and with the lowest GI compared to the freeze-thawing and acid methanol methods.

Physiological state of the hybrid Russian sturgeon × Siberian sturgeon (Acipenser gueldenstaedtii × Acipenser baerii) grown in cages in the Volga delta

Three-year-olds (15 individuals) and six-year-olds (15 individuals) of the hybrid Russian sturgeon × Siberian sturgeon (Acipenser gueldenstaedtii × Acipenser baerii), grown in net cages in the Volga delta, were studied at the end of the fishbreeding season in order to establish the functional state of the body according to a set of indicators of the erythron and metabolism. The results of the study revealed that the erythron system in six-year-old ROLO hybrids is characterized by a lower content of erythrocytes and blood hemoglobin (0.37±0.02 × 10¹²/l and 51.32±1.38 g/l, respectively), compared with three-year-olds (0.47±0.03 × 10¹²/l and 59.08±2.38 g/l, respectively) (p &lt; 0.05). The content of serum iron in the groups of three-year-olds and six-year-olds did not differ (15.05±0.62 and 14.63±0.42 µmol/l, respectively) (p &gt; 0.05). It has been established that indicators of protein metabolism in ROLO have age-related features. Thus, six-year-old hybrids have a higher level of whey protein content (39.3±1.34 g/l) and AST activity (4.71±0.11 µkat/l), but a lower level of ALT activity (1.67±0.18 µkat/l), compared with three-year-olds, in which the average values of these indicators were, respectively, 31.84±0.92 g/l, 3.05±0.39 and 2.58±0.16 mkat/l. Age differences were also found in the study of lipid metabolism. In the group of six-year-olds, the cholesterol content was lower than in three-year-olds (1.67±0.11 and 2.05±0.1 mmol/l, respectively) (p &gt; 0.05). But the content of serum triglycerides did not differ significantly, only a tendency to a higher level of this indicator in six-year-olds compared to three-year-olds was noted (3.07±0.14 and 2.28±0.11 mmol/l, respectively). When studying carbohydrate metabolism, a higher level of glycemia was found in the group of six-year-olds compared to three-year-olds: 2.52±0.16 and 1.68±0.15 mmol/l, respectively (p &gt; 0.05). The pronounced variability of the glycemia index in both groups is characteristic — the coefficient of variation was at the level of 25.3–33.6%. The established parameters of variation and age specificity of indicators of the erythron system, protein, lipid and carbohydrate metabolism can be used in assessing the state of physiological adaptation of the ROLO hybrid at the end of the growing period in cages in the Volga delta.

The glycemic status determines the direction of the relationship between red cell distribution width and HbA1c.

Available studies conducted on heterogenous populations on the association between the erythrocyte distribution width (RDW) and HbA1c have reported a positive, negative or neutral relationship. The aim of the present study is to investigate the debated relationship between RDW and HbA1c among hematologically healthy individuals with and without type 2 diabetes mellitus (T2DM). Paired measurements of RDW and HbA1c of 183 hematologically healthy individuals (100 without DM, 83 with T2DM) were obtained. The association of HbA1c with a) hematologic parameters (hemoglobin, log[ferritin], RDW) and b) factors related to glycemia (BMI, fructosamine, FPG) was examined within each group separately and in the sum of the study sample. There was a significant positive correlation of RDW with HbA1c among those without DM while the opposite was true among individuals with T2DM (r=0.315, p=0.001 and r=-0.275, p=0.011). In the T2DM group a significant negative correlation with fructosamine was noted (r=-0.274, p=0.012) which was absent among normoglycemic individuals. Among those without DM the association between HbA1c and RDW remained significant after adjustment for all tested parameters. In the population with T2DM the significance was attenuated after including glycemia-related factors values. In multivariable regression in the sum of the study sample, the interaction between diabetes status and RDW as regards HbA1c was significant [unstandardized correlation coefficient-0.397 (-0.646 to -0.147), p=0.002] and remained significant after adjustment for multiple potential confounders. Among individuals without DM, the RDW likely reflects the non-glycemic interference on HbA1c values, while in T2DM RDW may serve as an indirect index of glycemia and dysmetabolism.

Diabetes Mellitus and Periodontitis Share Intracellular Disorders as the Main Meeting Point

Diabetes and periodontitis are two of the most prevalent diseases worldwide that negatively impact the quality of life of the individual suffering from them. They are part of the chronic inflammatory disease group or, as recently mentioned, non-communicable diseases, with inflammation being the meeting point among them. Inflammation hitherto includes vascular and tissue changes, but new technologies provide data at the intracellular level that could explain how the cells respond to the aggression more clearly. This review aims to emphasize the molecular pathophysiological mechanisms in patients with type 2 diabetes mellitus and periodontitis, which are marked by different impaired central regulators including mitochondrial dysfunction, impaired immune system and autophagy pathways, oxidative stress, and the crosstalk between adenosine monophosphate-activated protein kinase (AMPK) and the renin-angiotensin system (RAS). All of them are the shared background behind both diseases that could explain its relationship. These should be taken in consideration if we would like to improve the treatment outcomes. Currently, the main treatment strategies in diabetes try to reduce glycemia index as the most important aspect, and in periodontitis try to reduce the presence of oral bacteria. We propose to add to the therapeutic guidelines the handling of all the intracellular disorders to try to obtain better treatment success.

Vitamin D Deficiency and Metabolic Sindroms: Literature Review

Based on current research, lack of micronutrients, especially Vitamin D, is thought to be associated with metabolic disorders. A good understanding of vitamin D deficiency as a risk factor for metabolic disorders is the basis for establishing policies and programs. This study aimed to determine the relationship between vitamin D and metabolic syndrome (MetS) and its parameters. Search for articles in literature review through Scientdirect, PubMed, Medline, and Google Scholar were publication periods between 2010-2019. Vitamin D/serum 25 (OH) D levels is associated with obesity, hypertention, glycemia index but studies relating vitamin D deficiency and lipid profiles have not shown consistent results. Most of research found association of Vitamin D and Metabolic Syndrome (MetS). Based on the review, most of the study results indicate that Vitamin D is associated with parameters in the metabolic syndrome, so that Vitamin D could be a new risk factor for MetS

Is There is a Correlation between Vitamin D Status and Glycemic Control (HBa1c) in Patients with Type 2 Diabetes Mellitus: Review Article with Meta-Analysis

Background and Purpose: Diabetes mellitus type 2 represent significant problem for health care givers because of its huge prevalence.The clue for non-skeletal impact of vitamin D become increasing suggesting the potential benefit in many diseases related to cardiac system, immunity disorders and diabetes mellitus type 2.We achieved this systematic review containing cross-sectional studies to assess the association between vitamin D status glycaemiaindex as represented by glycosylated hemoglobin.Method: We achieved literature search for cross-sectional studies which consider the impact of status of vitamin D on HBa1c as major outcome of interest. The author targets database like Medline and google scholar database for cross-sectional trials for period up to December 2020. The software utilized to analyze the data statistically was comprehensive meta-analysis (CMA).Results: Eighteen clinical trials have been identified by search.Thirteen studies found the inverse correlation between glycemic index (HBa1c) and patient’s status of vitamin D.It was founded that the overall combined influence of vitamin D level on glycosylated hemoglobinwas significant (p = 0.001, and 95% CI: - 0.230 to -3.268).Conclusion: The current review revealed that the impact of status of vitamin D in correction of glycaemia was significant. Thepatient’s vitamin D status can has important impact on the pathogenesis of T2DM. The diabetic patients with poor indices of glycaemia has higher prevalence of decreased vitamin D level referring to potential benefit of vitamin D in correction of such indices.

Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes.

This study aimed to investigate the influence of residual β-cell function on counterregulatory hormonal responses to hypoglycemia during acute physical exercise in people with type 1 diabetes (T1D). A secondary aim was to explore relationships between biomarkers of pancreatic β-cell function and indices of glycemia following acute exercise including the nocturnal period. This study involved an exploratory, secondary analysis of data from individuals with T1D who partook in a four-peroid, randomized, cross-over trial involving a bout of evening exercise followed by an overnight stay in a clinical laboratory facility. Participants were split into two groups: (i) a stimulated C-peptide level of ≥30 pmol⋅L-1 (low-level secretors [LLS], n = 6) or (ii) <30 pmol⋅L-1 (microsecretors [MS], n = 10). Pancreatic hormones (C-peptide, proinsulin, and glucagon), catecholamines (epinephrine [EPI] and norepinephrine [NE]), and metabolic biomarkers (blood glucose, blood lactate, and β-hydroxybutyrate) were measured at rest, during exercise with and without a hypoglycemic (blood glucose ≤3.9 mmol⋅L-1) episode, and throughout a 13-h postexercise period. Interstitial glucose monitoring was used to assess indices of glycemic variability. During in-exercise hypoglycemia, LLS presented with greater sympathoadrenal (EPI and NE P ≤ 0.05) and ketone (P < 0.01) concentrations. Glucagon remained similar (P = 0.09). Over exercise, LLS experienced larger drops in C-peptide and proinsulin (both P < 0.01) as well as greater increases in EPI (P < 0.01) and β-hydroxybutyrate (P = 0.03). LLS spent less time in the interstitial-derived hypoglycemic range acutely postexercise and had lower glucose variability throughout the nocturnal period. Higher residual β-cell function was associated with greater sympathoadrenal and ketonic responses to exercise-induced hypoglycemia as well as improved glycemia leading into and throughout the nocturnal hours. Even a minimal amount of residual β-cell function confers a beneficial effect on glycemic outcomes during and after exercise in people with T1D.

ISSUE HIGHLIGHTS

BioFactorsVolume 46, Issue 4 ISSUE HIGHLIGHTSFree Access ISSUE HIGHLIGHTS First published: 17 August 2020 https://doi.org/10.1002/biof.1672AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat 502 A systematic review and meta-analysis of the effect of Vitamin D-fortified food on glycemic indices Maryam Emadzadeh, Reza Sahebi, Hamed Khedmatgozar, Ramin Sadeghi, Mahsa Farjami, Payam Sharifan, Yalda Ravanshad, Gordon A. Ferns and Majid Ghayour-Mobarhan Some reports indicated that Vitamin D may improve glycaemia indices in diabetic patients. The aim of this systematic and meta-analysis was to evaluate effects of Vitamin D fortification on indices of glycemic control. Six databases (PubMed/Medline, ISI Web of Knowledge, Cochrane Library, Science Direct, Scopus, and Google Scholar) were searched, for randomized controlled trials that were published up to September 2018 and that compared the effect of Vitamin D-fortified food versus regular diet in relation to glycemic control. Of the 4,379 studies originally found, 11 articles remained to be assessed for meta-analysis. Vitamin D fortification was associated with a significant improvement in fasting serum glucose (mean difference [MD]: −2.772; 95% confidence interval [CI]: −5.435 to −0.109) and fasting serum insulin (MD: −2.937; 95% CI: −4.695 to −1.178) in patients with Type 2 diabetes mellitus. A diet with food enriched with Vitamin D was associated with a significant improvement in homeostatic model assessment of insulin resistance (MD: −1.608; 95% CI: −3.138 to −0.079) but was not associated with a significant reduction in hemoglobin A1C (MD: 0.034; 95% CI: −0.655 to 0.069). This meta-analysis indicates that Vitamin D fortification improves indices of glycemic control. Hence, food fortified with Vitamin D may be of potential therapeutic value in diabetic patients, as an adjuvant therapy. Figure 1Open in figure viewerPowerPoint 514 New insights into the core Hippo signaling and biological macromolecules interactions in the biology of solid tumors Solmaz Mohammadi, Reza Arefnezhad, Shahla Danaii and Mehdi Yousefi As an evolutionarily conserved pathway, Hippo signaling pathway impacts different pathology and physiology processes such as wound healing, tissue repair/size and regeneration. When some components of Hippo signaling dysregulated, it affects cancer cells proliferation. Moreover, the relation Hippo pathway with other signaling including Wnt, TGFβ, Notch, and EGFR signaling leaves effect on the proliferation of cancer cells. Utilizing a number of therapeutic approaches, such as siRNAs and long noncoding RNA (lncRNA) to prevent cancer cells through the targeting of Hippo pathways, can provide new insights into cancer target therapy. The purpose of present review, first of all, is to demonstrate the importance of Hippo signaling and its relation with other signaling pathways in cancer. It also tries to demonstrate targeting Hippo signaling progress in cancer therapy. Figure 2Open in figure viewerPowerPoint REFERENCES 1Maryam Emadzadeh, Reza Sahebi, Hamed Khedmatgozar, Ramin Sadeghi, Mahsa Farjami, Payam Sharifan, Yalda Ravanshad, Gordon A. Ferns and Majid Ghayour-Mobarhan. A systematic review and meta-analysis of the effect of Vitamin D-fortified food on glycemic indices. BioFactors. 2020; 46: 502– 513. 2Solmaz Mohammadi, Reza Arefnezhad, Shahla Danaii and Mehdi Yousefi. New insights into the core Hippo signaling and biological macromolecules interactions in the biology of solid tumors. BioFactors. 2020; 46: 514– 530. Volume46, Issue4July/August 2020 FiguresReferencesRelatedInformation

Glycemia and Atherosclerotic Cardiovascular Disease: Exploring the Gap Between Risk Marker and Risk Factor.

There is consistent, unequivocal and reproducible epidemiological evidence derived from diverse populations that various indices of glycemia (fasting plasma glucose, post-prandial or post oral glucose challenge plasma glucose, HbA1c) are associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), even in the prediabetic state. Furthermore, there is abundant experimental evidence demonstrating that hyperglycemia per se accelerates and aggravates the atherosclerotic process, providing biological plausibility to the concept that hyperglycemia is causally related or a true risk factor for ASCVD. Two studies in particular, DCCT and UKPDS, that enrolled a younger cohort of patients with type 1 diabetes or an older cohort with newly diagnosed type 2 diabetes, respectively, showed trends toward a reduction in ASCVD. The reductions in ASCVD reached statistical significance only after prolonged follow up, and when differences in HbA1c were no longer maintained (referred to by some as a “legacy effect”). More recent studies in those with established type 2 diabetes, in which glycemic control was improved by a variety of strategies, failed to demonstrate reductions in ASCVD. The gap in evidence supporting hyperglycemia as a true causative risk factor for ASCVD or simply a risk marker for some other confounding causative factor is discussed in this review. We conclude that hyperglycemia does appear to be at least partially causative of ASCVD (i.e., an ASCVD risk factor). We discuss how this evidence can be incorporated into an overall therapeutic strategy to prevent ASCVD in those with prediabetes and established diabetes.

A systematic review and meta-analysis of the effect of Vitamin D-fortified food on glycemic indices.

Some reports indicated that Vitamin D may improve glycaemia indices in diabetic patients. The aim of this systematic and meta-analysis was to evaluate effects of Vitamin D fortification on indices of glycemic control. Six databases (PubMed/Medline, ISI Web of Knowledge, Cochrane Library, Science Direct, Scopus, and Google Scholar) were searched, for randomized controlled trials that were published up to September 2018 and that compared the effect of Vitamin D-fortified food versus regular diet in relation to glycemic control. Of the 4,379 studies originally found, 11 articles remained to be assessed for meta-analysis. Vitamin D fortification was associated with a significant improvement in fasting serum glucose (mean difference [MD]: -2.772; 95% confidence interval [CI]: -5.435 to -0.109) and fasting serum insulin (MD: -2.937; 95% CI: -4.695 to -1.178) in patients with Type 2 diabetes mellitus. A diet with food enriched with Vitamin D was associated with a significant improvement in homeostatic model assessment of insulin resistance (MD: -1.608; 95% CI: -3.138 to -0.079) but was not associated with a significant reduction in hemoglobin A1C (MD: 0.034; 95% CI: -0.655 to 0.069). This meta-analysis indicates that Vitamin D fortification improves indices of glycemic control. Hence, food fortified with Vitamin D may be of potential therapeutic value in diabetic patients, as an adjuvant therapy.

Cutoff point estimation for serum vitamin D concentrations to predict cardiometabolic risk in Brazilian children.

To evaluate serum 25(OH)D concentrations and determine a cutoff point for cardiometabolic risk in children. This is a cross-sectional study with a representative sample of 378 8-9-year-old children from all urban schools in the city of Viçosa, MG, Brazil. Sociodemographic data and information on lifestyle, and food consumption were collected. Biochemical evaluation included glucose, triglycerides, leptin, calcidiol [25(OH)D], and parathormone. Body composition was assessed by dual energy X-ray absorptiometry. Cardiometabolic risk was considered when nontraditional risk markers were detected, including triglyceride × glycemia index (TyG index), hyperleptinemia, and hypertriglyceridemic waist phenotype (HWP). The receiver operating characteristic curve (ROC) was used to define the cutoff point for serum 25(OH)D to predict cardiometabolic risk. 25(OH)D showed better predictive capacity for grouping of cardiometabolic risk markers than for either single or paired markers. The area under the curve for grouping of risk markers was 0.636 (95% CI: 0.585, 0.685, P < 0.001). The cutoff point to predict cardiometabolic risk was defined as 32.0 ng/mL. 25(OH)D presented good predictive capacity for cardiometabolic risk and 25(OH)D concentration higher than 32 ng/mL was associated with a 49% reduction of cardiometabolic risk prevalence in prepubertal Brazilian children.

Энергетическая потребность покоя и экскреция азота с мочой при стрессовой гипергликемии в раннюю фазу острого тяжелого панкреатита

Purpose. To investigate the features of resting energy expenditure and urinary nitrogen excretion during stress-induced hyperglycemia at an early phase of acute severe pancreatitis. Materials and methods. The study design was a prospective single-center cohort study. The inclusion criteria were: diagnosed acute pancreatitis and at least one severity predictor. On day one, three, and five the dark blood glycemic index and urinary nitrogen excretion were measured and resting energy expenditure was determined in all patients. From the total number of cases (n = 72), a cohort of patients with severe acute pancreatitis was singled out (n = 23). In that cohort, three groups were formed. The first group included measurements made over the whole observation period (n = 69), the second – normoglycemia (n = 48), and the third one – hyperglycemia. Stress-induced hyperglycemia was determined as increased blood glucose ≥ 11.1 mmol/L. The raw data were statistically processed using SPSS package. The zero hypothesis was rejected at p &lt; 0.05. Results. A statistically significant difference was found between the second and third groups in the glycemia index (p &lt; 0.001) and urinary nitrogen excretion (p = 0.022), but not in the resting energy expenditure (p = 0.157). The prevalence of glycemia among the deceased amounted to 66.6% and among the survived – 17.2%. To make up the quantity of nitrogen lost with urine, the normoglycemia patients required an uptake of 117.1 nonprotein kcal per 1 g of nitrogen, and the hyperglycemia patients -61.7 kcal. Conclusion. At an early phase of acute severe pancreatitis, urinary nitrogen excretion rises in a statistically significant manner in patients with stress-induced hyperglycemia. To make up the urinary nitrogen loss, the normoglycemia patients require 117.1 nonprotein kcal per 1 g of nitrogen while hyperglycemia patients – 61.7.

GSTT1, Calpain 10 SNP 19 and indices of glycaemia in type 2 diabetes

GSTT1, Calpain 10 SNP 19 and indices of glycaemia in type 2 diabetes

1406-P: Associations between Indices of Glycemic Variability (GV) and Gestational Outcomes among Pregnant Women with Type 1 Diabetes (T1D)

Pregnancies associated with diabetes are at high risk of adverse health outcomes. We examined associations between indices of glycemia and GV, assessed by continuous glucose monitoring, and maternal and fetal outcomes in women with T1D. Women with T1D were stratified to groups during preconception or the 1st trimester: (1) CGM Alone (n=13): women without Apple devices, or (2) CGM Share (n=15, DexCom, San Diego, CA): women with iPhone and followers with data viewing devices. Association between change in GV indices over time and gestational outcomes were measured with linear mixed models. Preeclampsia developed in 28.6% (8/28) of women. Preeclampsia was significantly associated with higher estimated A1C, mean sensor glucose, and time spent &amp;gt;140 mg/dL, and with lower time spent &amp;lt;65 mg/dL and 65-140 mg/dL (Table 1). Gestational age at delivery was 36.7 ± 1.7 weeks (mean ± SD). Gestational age at delivery was associated with lower estimated A1C (0.11% decrease A1C per 1 week increased gestational age, p=0.02), mean sensor glucose, and time spent &amp;gt;140 mg/dL, and with higher time in range (Table 2). There were no associations found between GV indices and cesarean delivery, delivery &amp;lt;37 weeks, large-for-gestational age infants, birth weight, and neonatal hypoxemia. Preeclampsia and gestational age at delivery were associated with worse A1C and CGM metrics, but not with GV indices. Disclosure S. Polsky: Consultant; Self; Jaeb Center for Health Research. Research Support; Self; Barbara Davis Center for Diabetes, Children's Diabetes Foundation, Dexcom, Inc., Eli Lilly and Company, JDRF, Leona &amp; Harry Helmsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases, Sanofi US. L. Pyle: None. R. Garcetti: None. P. Joshee: None. J.K. Demmitt: None. T.B. Vigers: None. J.K. Snell-Bergeon: None. Funding Dexcom, Inc.; National Center for Research Resources/Colorado Clinical and Translational Science Institute (UL1RR025780)