Indices Of Metabolic Health Research Articles

The Relationship between Whole-Milk Dairy Foods and Metabolic Health Highlights an Opportunity for Dietary Fat Recommendations to Evolve with the State of the Science.

The science of dietary fats has evolved, and a body of evidence indicates they are complex bioactive nutrients that have different effects on health depending on their food source, chain length, degree of saturation, and other factors that can be affected by food processing, handling, and storage. As such, it is becoming increasingly clear that the effects of foods on obesity and metabolic health cannot be predicted simply with their fat content. The aim of this opinion article is to provide a brief overview of select recent research on the effects of whole-milk dairy foods on body composition and indicators of metabolic health across the lifespan to show the gap between current knowledge and dietary guidance. As the state of the science on dietary fats and human health evolves to consider the complexity of food matrices, the total nutrient package they deliver, and the health impacts associated with dietary patterns, so too must guidelines for dietary fat.

1237-P: Proteomic Indicators of Metabolic Health in Diabetes and Social Vulnerability

Introduction: Understanding the health impacts of socioeconomic deprivation (SED) and its interaction with type 2 diabetes is important for patient care and effective public health initiatives. Large-scale proteomic profiling using aptamer-based technology to measure 7,000 proteins has facilitated the development of blood-based proteomic signatures for 10 cardiometabolic SomaSignal Tests (SST), including a test that predicts the 4-year risk of a cardiovascular event (CV risk). Methods: The cross-sectional PsoBid study recruited participants from socioeconomically deprived and affluent areas of Glasgow, Scotland with similar age ranges and equal proportions of male and female, to identify relevant health disparities. We used regression analyses to estimate the association between SSTs and socioeconomic status (affluent (n = 257, 50.7%), deprived (n = 250, 49.3%)) and prevalent diabetes (n = 27 (5.3%), 7 (2.7%) affluent, 20 (8.0%) SV). Results: Diabetes was associated with SST predicted increased visceral fat, lean body mass, liver fat, body fat percentage, resting energy rate, and CV risk score, and worse proteomic predictors of cardiorespiratory fitness, glucose tolerance, alcohol impact, and kidney health (p<0.05). SED was associated with SST predicted increased visceral adiposity and CV risk score, and decreased cardiorespiratory fitness, glucose tolerance, and kidney health (p<0.05). The association between diabetes and CV risk score was highest among socioeconomically deprived participants (interaction p-value: 0.01). Conclusion: These results demonstrate that participants with diabetes and SED have proteomic phenotypes consistent with decreased cardiometabolic health compared to participants without diabetes or SV and SED is associated with worse predicted cardiovascular risk in patients with diabetes. Proteomics may be useful in identifying and monitoring the health effects of diabetes and SED or the impact of relevant interventions. Disclosure M.Simpson: Employee; SomaLogic Operating CO., Inc. R.Ostroff: Employee; SomaLogic. S.A.Williams: Employee; SomaLogic. N.Sattar: Advisory Panel; Amgen Inc., Boehringer Ingelheim and Eli Lilly Alliance, Novartis, Roche Diagnostics, Consultant; Afimmune Limited, Hanmi Pharm. Co., Ltd., Pfizer Inc., Other Relationship; Abbott, AstraZeneca, Boehringer Ingelheim Pharma GmbH&Co.KG, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Research Support; AstraZeneca, Boehringer Ingelheim Pharma GmbH&Co.KG, Novartis, Roche Diagnostics.

Abstract A025: Elevated periprostatic fat is associated with high grade prostate cancer in radiotherapy-treated patients

Abstract Introduction Obesity is associated with poor prostate cancer-specific outcomes. Body mass index, a commonly used surrogate of obesity, does not adequately describe fat distribution, which can instead be assessed using medical imaging. Abdominal visceral obesity, a better indicator of metabolic health, has been associated with increased prostate cancer risk. Similarly, periprostatic adipose tissue (PPAT), a type of visceral fat in close proximity to the prostate has a postulated role in prostate cancer aggressiveness. We hypothesised that elevated quantities of visceral fat, both abdominal and periprostatic would be associated with increased disease aggressiveness. To gain insight into potential contributing mechanisms, we examined gene expression pathways differentially expressed in association with adiposity measures. Methods Abdominal adipose tissue, both subcutaneous and visceral (n=244), and PPAT (n=309) were quantified from the radiation planning computed tomography (CT) scans from prostate cancer patients treated with radiotherapy and ADT in the Northern Ireland Cancer Centre between 2005-2009. Abdominal fat was measured at L4/L5 and PPAT at the midpoint of pubic symphysis using a threshold of -190 to -30 Hounsfield Units to identify fat. Associations of adipose tissue quantity, categorised using tertiles of fat quantity, with Gleason score (≥4+3 versus ≤3+4) were assessed using univariable and multivariable logistic regression analysis. Associations between adipose tissue quantity and risk of biochemical recurrence and metastasis were examined using Cox regression. In a subset of patients with tumour biopsy transcriptomic data (n=183), an exploratory Gene Set Enrichment Analysis (GSEA) was performed to identify enriched gene pathways in the tumours of those with high versus low fat measures, defined using the median fat quantity. Results High PPAT was significantly associated with increased risk of high grade prostate cancer (Tertile 3 vs. Tertile 1; age adjusted OR 2.05; 95%CI 1.17-3.62; p=0.01). There was a trend for increased risk of high grade disease in those with high abdominal subcutaneous (T3 vs. T1; age adjusted OR 1.73; 95%CI 0.92-3.30) and visceral (T3 vs. T1; age adjusted OR 1.21; 95%CI 0.66-2.25) fat measures but this was not significant. In GSEA, those with high PPAT showed enrichment of the KEGG adipocytokine signalling pathway (nominal p-value=0.004) whilst those with high subcutaneous fat had enrichment of pathways involved in lipid and cholesterol metabolism. No adipose tissue measure was significantly associated with prostate cancer-specific outcomes following a median follow up of 10.1 years. Conclusions Elevated quantities of PPAT are associated with increased risk of high grade prostate cancer and enriched tumour adipocytokine signalling, suggesting a possible paracrine role of PPAT in prostate cancer aggressiveness. This is the first study to explore potential mechanisms of PPAT using tumour gene expression data. If confirmed, this may in part explain the link between obesity and aggressive prostate cancer. Citation Format: Sarah J. Winter, Suneil Jain, Gillian Prue, Conor K. McGarry, Alan R. Hounsell, Michelle Leech, Emma H. Allott. Elevated periprostatic fat is associated with high grade prostate cancer in radiotherapy-treated patients [abstract]. In: Proceedings of the AACR Special Conference: Advances in Prostate Cancer Research; 2023 Mar 15-18; Denver, Colorado. Philadelphia (PA): AACR; Cancer Res 2023;83(11 Suppl):Abstract nr A025.

Ethnic differences in complement system biomarkers and their association with metabolic health in men of Black African and White European ethnicity.

Inflammation plays a fundamental role in the development of several metabolic diseases, including obesity and type 2 diabetes (T2D); the complement system has been implicated in their development. People of Black African (BA) ethnicity are disproportionately affected by T2D and other metabolic diseases but the impact of ethnicity on the complement system has not been explored. We investigated ethnic differences in complement biomarkers and activation status between men of BA and White European (WE) ethnicity and explored their association with parameters of metabolic health. We measured a panel of 15 complement components, regulators, and activation products in fasting plasma from 89 BA and 96 WE men. Ethnic differences were statistically validated. Association of complement biomarkers with metabolic health indices (BMI, waist circumference, insulin resistance, and HbA1c) were assessed in the groups. Plasma levels of the key complement components C3 and C4, the regulators clusterin and properdin and the activation marker iC3b were significantly higher in BA compared to WE men after age adjustment, while FD levels were significantly lower. C3 and C4 levels positively correlated with some or all markers of metabolic dysfunction in both ethnic groups while FD was inversely associated with HbA1c in both groups, and clusterin and properdin were inversely associated with some markers of metabolic dysfunction only in the WE group. Our findings of increased levels of complement components and activation products in BA compared to WE men suggest differences in complement regulation that may impact susceptibility to poor metabolic health.

GLUCOSE INTOLERANCE PREDICTS CARDIORESPIRATORY FITNESS IN A HEALTHY POPULATION

https://youtu.be/oIXKiLYDh6g BACKGROUND Aerobic capacity or maximum oxygen consumption rate (VO2max) is accepted as the single best indicator of cardiorespiratory fitness. VO2max is also an indicator of metabolic health and known as an all-cause mortality predictor. It is well established that glucose intolerance and insulin resistance in patients with diabetes is associated with decline in cardiorespiratory fitness. However, it is not clear if glucose intolerance is associated with poorer cardiorespiratory fitness in a population without diabetes. Therefore, the purpose of this study was to assess if glucose intolerance measured by oral glucose tolerance test (OGTT) is associated with cardiorespiratory fitness in a population without diabetes. METHODS Fifty one (30 males and 21 females) predominantly Mexican-American adults without diabetes (Age 26.1 ± 5.3 years; BMI 26.7 ± 4.2 kg/m2; fasting blood glucose 92.1 ± 10.0 mg/dL) from the border region of El Paso, TX participated in this study. VO2max was assessed using a standardized graded exercise test protocol on a treadmill with Parvomedics metabolic cart. Glucose tolerance was measured by a 3-hour OGTT preformed after a 12-hour overnight fast. Blood glucose measured at fasting and every 30 minutes after the ingestion of 75g of glucose drink during OGTT and glucose area under the curve was determined to access glucose tolerance. Pearson correlation analysis was performed at 0.05 significance level. RESULTS Glucose intolerance measured by glucose area under the curve was negatively correlated with VO2max (r = −0.40, p = 0.006). Additionally, blood glucose level during OGTT test at 120 min (r = −0.43, p = 0.003), 150 min (r = −0.36, p = 0.014), and 180 min (r = −0.32, p = 0.048) were also negatively associated with VO2max. However, fasting blood glucose was not associated with VO2max (r = −0.09, p = 0.56). CONCLUSION Poorer cardiorespiratory fitness is indicated by greater glucose intolerance and a greater surge of glucose level during an OGTT, but not fasting blood glucose in a population without diabetes.

Effects of physical activity type and sedentary time on metabolically healthy obesity and metabolically unhealthy normal weight Korean men

Obesity has become a global health challenge linked to morbidity and mortality associated with cardiovascular diseases. This study aimed to compare metabolic health indicators according to obesity phenotypes and examine prevalence according to physical activity (PA) and sedentary time in metabolically healthy obesity (MHO) and metabolically unhealthy normal weight (MUNW). Data were obtained from 3242 men participating in the 7th and 8th Korean National Health and Nutrition Examination Surveys. Participants were divided into four groups based on body phenotype and metabolic health status using obesity. Metabolic health was defined as metabolic syndrome. Representative statistical analyzes were one-way analysis of variance (ANOVA) and multiple logistic regression analysis. Compared with MUNW, the MHO had higher obesity, but systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), hemoglobin A1c (HbA1c), triglycerides (TG), low density lipoprotein cholesterol (LDLC), and total cholesterol (TC) were significantly lower. In comparison between MHO and metabolically healthy normal weight (MHNW), the same health group, there were no significant differences in SBP, FG, HbA1c, and LDLC. The odds ratio of MUNW in the normal weight group was 1.8 times higher than that of the high group in the low leisure PA group. The group with high sedentary time increased the MUNW odds ratio by 1.5 times compared to the low group. Meanwhile, in the obesity group, the high leisure PA group showed a 1.4-fold increase in the MHO odds ratio compared to the low group. In addition, the low sedentary group showed a 1.6-fold increase in the MHO odds ratio compared to the high sedentary group. In conclusion, MHO had higher adiposity than MUNW, but the metabolic health index was better. Low PA and high sedentary time increased the risk of MUNW even in normal weight. Conversely, high PA and low sedentary time increased the likelihood of MHO in the obesity group.

Gut microbial indicators of metabolic health underlie age-related differences in obesity and diabetes risk among Native Hawaiians and Pacific Islanders.

Native Hawaiians and Pacific Islanders (NHPIs) suffer from higher prevalence of and mortality to type 2 diabetes mellitus (T2DM) than any other major race/ethnic group in Hawaii. Health inequities in this indigenous population was further exacerbated by the SARS-CoV-2 pandemic. T2DM progression and medical complications exacerbated by COVID-19 are partially regulated by the gut microbiome. However, there is limited understanding of the role of gut bacteria in the context of inflammation-related diseases of health disparities including T2DM and obesity. To address these gaps, we used a community-based research approach from a cohort enriched with NHPI residents on the island of Oahu, Hawaii (N=138). Gut microbiome profiling was achieved via 16s rDNA metagenomic sequencing analysis from stool DNA. Gut bacterial capacity for butyrate-kinase (BUK)-mediated fiber metabolism was assessed using quantitative PCR to measure the abundance of BUK DNA and RNA relative to total bacterial load per stool sample. In our cohort, age positively correlated with hemoglobin A1c (%; R=0.39; P<0.001) and body mass index (BMI; R=0.28; P<0.001). The relative abundance of major gut bacterial phyla significantly varied across age groups, including Bacteroidetes (P<0.001), Actinobacteria (P=0.007), and Proteobacteria (P=0.008). A1c was negatively correlated with the relative levels of BUK DNA copy number (R=-0.17; P=0.071) and gene expression (R=-0.33; P=0.003). Interestingly, we identified specific genera of gut bacteria potentially mediating the effects of diet on metabolic health in this cohort. Additionally, α-diversity among gut bacterial genera significantly varied across T2DM and BMI categories. Together, these results provide insight into age-related differences in gut bacteria that may influence T2DM and obesity in NHPIs. Furthermore, we observed overlapping patterns between gut bacteria and T2DM risk factors, indicating more nuanced, interdependent interactions among these factors as partial determinants of health outcomes. This study adds to the paucity of NHPI-specific data to further elucidate the biological characteristics associated with pre-existing health inequities in this racial/ethnic group that is significantly underrepresented in biomedical research.

Effects of short-term exposure to gaseous pollutants on metabolic health indicators of patients with metabolic syndrome in Northwest China

Currently few studies have explored the relationship between exposure to gaseous pollutants and metabolic health indicators in patients, especially in patients with metabolic syndrome (Mets). This study collected 15,520 patients with Mets in a prospective cohort of nearly 50,000 people with 7 years of follow-up from 2011 to 2017, and matched air pollutants and meteorological data during the same period. The mixed effects model was used to analyze the relationship between different short exposure windows (1-week, 1-month, 2-month, and 3-month) of gaseous pollutants (SO2, NO2, and O3) and the metabolic health indicators of patients after controlled the confounding factors. Stratified analysis was performed by demographic characteristics and behavioral factors. The effects of gaseous pollutants on patients with different Met components were also analyzed. The results showed that the short-term exposure to SO2, NO2, and O3 had a certain effect on the metabolic health indicators of patients with Mets in different exposure windows, and with the extension of the exposure window period, the effects increased. The stratified analysis showed that gender, age, and life behaviors might modify these detrimental effects. In addition, the effects of gaseous pollutants on metabolic health indicators in G4 and G7 were more obvious than other Met components, and the effects of gaseous pollutants on the level of LDL-C were found to be statistically significant in most components. Therefore, patients with Mets should pay more attention to the influence of gaseous pollutants to take appropriate protection to reduce potential health risk.

Longitudinal association between triglyceride glucose index and depression progression in middle-aged and elder adults: A national retrospective cohort study

Background and aimsPsychological symptoms are prevalent among individuals with non-communicable diseases, while the longitudinal association between triglyceride glucose (TyG) index, an indicator of metabolic health, and depression progression remains unclear yet. This study aims to investigate the association of baseline TyG index and depression progression in middle-aged and elder adults. Methods and resultsThis retrospective cohort study enrolled 8287 participants aged 45 years or above from national China Health and Retirement Longitudinal Study in visit 1 (2011–2012), which were biennially followed for depression score until visit 4 (2017–2018). Multivariate-adjusted regression models were used to evaluate the association of baseline TyG index with the individual level change rate and slope of depression score. The mean age (±SD) of participants was 58.25 ± 9.10 years, and 3806 (45.9%) were men. There was no significant difference of depression score at baseline across TyG quartile groups (P = 0.228). Participants in the highest quartile of TyG index had a 0.124 (95% CI: 0.018–0.230) higher change rate of depression score, and a 0.127 (95% CI: 0.019–0.235) higher change slope, compared to those in the lowest. The observed associations were consistent in multiple sensitivity analyses, and stable in men, the elder, and overweight people. ConclusionTyG index is positively associated with depression progression especially in men, the elder and overweight people, which provides new insights for the primary prevention of depression disorder.

Effects of peripartal glucose precursor supplementation on lactation performance and metabolic health of primiparous and multiparous dairy cows.

Hyperketonemia remains a major metabolic issue of serious milk production and a major health concern in early lactation cows. Oral supplementation of glucose precursors (GP) can be used to prevent hyperketonemia in dairy cows. The objective of this study was to compare the beneficial effects of orally supplementing a mixture of GP on metabolic health indicators and milk production status of primiparous (PP) and multiparous (MP) dairy cows. Twenty-eight Holstein cows were blocked by expected date of parturition, previous lactation yield, and parity. The cows were randomly allocated to one of the four treatment groups (n = 7 cows/group) based on their parity and GP supplementation: i) PP cows fed basal diet only (PP-CON), ii) PP cows with oral supplementation of GP (PP-GP), iii) MP cows fed basal diet only (MP-CON), and iv) MP cows with oral supplementation of GP (MP-GP). Glucose precursor (glycoline liquid) was orally drenched (300 mL/d) in GP cows from 7 days prepartum through 7 days postpartum. Other than GP supplementation, all cows were fed similar pre- and postpartum basal diets. In both pre- and postpartum periods, serum glucose concentration was increased, whereas β-hydroxybutyrate and free fatty acids were decreased in GP cows compared with the CON cows. Milk yield and milk components were statistically not different between GP and CON cows over the first 9 week of lactation. The yield of actual milk, energy-corrected milk, 63-days cumulative milk, colostrum yield, and calf birth weight remained higher in MP cows compared with PP cows. Oral drenching of GP around calving can be recommended to successfully improve the metabolic health and reduce the negative effects of hyperketonemia not only in MP but also in PP dairy cows.

Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study.

The menopause transition is associated with unfavourable alterations in health. However, postprandial metabolic changes and their mediating factors are poorly understood. The PREDICT 1 UK cohort (n=1002; pre- n=366, peri- n=55, and post-menopausal females n=206) assessed phenotypic characteristics, anthropometric, diet and gut microbiome data, and fasting and postprandial (0-6h) cardiometabolic blood measurements, including continuous glucose monitoring (CGM) data. Differences between menopausal groups were assessed in the cohort and in an age-matched subgroup, adjusting for age, BMI, menopausal hormone therapy (MHT) use, and smoking status. Post-menopausal females had higher fasting blood measures (glucose, HbA1c and inflammation (GlycA), 6%, 5% and 4% respectively), sugar intakes (12%) and poorer sleep (12%) compared with pre-menopausal females (p<0.05 for all). Postprandial metabolic responses for glucose2hiauc and insulin2hiauc were higher (42% and 4% respectively) and CGM measures (glycaemic variability and time in range) were unfavourable post- versus pre-menopause (p<0.05 for all). In age-matched subgroups (n=150), postprandial glucose responses remained higher post-menopause (peak0-2h 4%). MHT was associated with favourable visceral fat, fasting (glucose and insulin) and postprandial (triglyceride6hiauc) measures. Mediation analysis showed that associations between menopause and metabolic health indicators (visceral fat, GlycA360mins and glycaemia (peak0-2h)) were in part mediated by diet and gut bacterial species. Findings from this large scale, in-depth nutrition metabolic study of menopause, support the importance of monitoring risk factors for type-2 diabetes and cardiovascular disease in mid-life to older women to reduce morbidity and mortality associated with oestrogen decline. Zoe Ltd.

Risky Early Family Environment and Genetic Associations with Adult Metabolic Dysregulation.

Growing up in a family environment characterized by neglectful parenting, overt conflict, and unsupportive relationships is associated with poor health in adulthood. A risky early family environment may also be associated with obesity in adulthood, likely through the activation of the HPA axis. Likewise, the GABAergic (gamma-aminobutyric acid) T>C single nucleotide polymorphism in the 1519 nucleotide position of the GABAAα6 receptor subunit gene has been associated with a predisposition to a higher body mass index and a larger waist circumference. Participants (n = 213, Mage = 30.13 years, SD = 10.85; 57.7% men) from the Pittsburgh Cold Study 3 completed a demographic questionnaire, the Risky Families Questionnaire (RFQ) and had their height, weight, and waist circumference measured during a physical exam. Participant DNA was recovered from buccal swabs and genotyped for the various allelic types of the SNP according to published protocols. In secondary data analyses, we tested the hypothesis that early family environment and GABRA6 would be positively associated with body mass index and waist circumference. We also examined diurnal cortisol as a mechanism linking both early risky family environment and GABRA6 to metabolic outcomes. The findings provide evidence that a risky early family environment may exert more influence than genetic predisposition when determining the indices of metabolic health in adulthood.

The effect of sun light exposure on prediabetic patients in tamil nadu population

This study examines the impact of sunlight exposure on metabolic health indicators in prediabetic individuals in Tamil Nadu, with a focus on its potential to reduce the risk of Type 2 diabetes mellitus (T2DM). Prediabetes, characterized by elevated glucose levels, is a major risk factor for both T2DM and cardiovascular diseases. With projections that diabetes will affect 380 million people globally by 2025, including 70 million in India, early intervention is critical. Vitamin D, synthesized through sunlight exposure, plays a role in insulin sensitivity and glucose regulation. Vitamin D deficiency has been linked to increased insulin resistance and higher HbA1c levels, particularly among those with obesity, a common risk factor in prediabetes. This retrospective study included 100 prediabetic patients, divided based on sunlight exposure, and followed over three years. Key anthropometric and metabolic parameters such as BMI, blood glucose, HbA1c, and lipid profiles were assessed. Results showed that the sunlight-exposed group had significant improvements in BMI, blood glucose, and HbA1c compared to those with low sunlight exposure, with blood pressure also improving, though HDL and LDL cholesterol changes were not statistically significant. These findings suggest that regular sunlight exposure may help delay or prevent diabetes progression by improving metabolic health, especially when combined with lifestyle modifications and Vitamin D supplementation. Further research is recommended to determine optimal sunlight exposure guidelines for high-risk groups.

STUDY OF FASTING PLASMA GLUCOSE AND LIPID PROFILE IN POSTMENOPAUSAL WOMEN

Objectives: The study was designed to determine fasting plasma glucose (FPG) and lipid profiles in postmenopausal women. Methods: 200 postmenopausal women were enrolled for the study and were compared to 100 normal healthy women of the same age from the Outdoor Patient Department of LN Medical College and research center of Bhopal city. Those fulfilling inclusion and exclusion criteria were enrolled for the study and the blood samples were analyzed for lipid profile and FPG. Results: Significant higher concentrations of total cholesterol (p&lt;0.001), triglyceride (p&lt;0.001), low-density lipoprotein (LDL) (p&lt;0.001), very LDLs (p&lt;0.001), and FPG (p&lt;0.001) were demonstrated in postmenopausal women when compared with normal healthy women. A significantly lower concentration of high-density lipoprotein (p&lt;0.001) was demonstrated in postmenopausal women when compared with normal healthy women. Conclusion: Menopausal transition and the related changes in the hormonal milieu (e.g., decreased systemic estradiol (E2) levels) are linked with adverse changes in several indicators of metabolic health. For instance, during the menopausal transition elevated blood glucose levels and adverse changes in serum lipids have been reported.

Measures of Maternal Metabolic Health as Predictors of Severely Low Milk Production.

Background:A comprehensive approach to breastfeeding support requires elucidation of how metabolic health influences milk production.Objective:We compared metabolic health indicators in women with severely low milk output versus those with moderate/normal milk output using a case–control study design, with nested and external control groups.Design:Cases and nested controls were derived from women screened for a low milk supply trial, with cases defined as severely low milk output (<300 mL/24 hours), and nested controls defined as moderate/normal milk output (>300 mL/24 hours). In addition, we included an external control group of exclusively breastfeeding women. All were enrolled at 2–10 weeks postdelivery of a healthy term infant. Milk output and breast emptying frequency were recorded through test-weigh. Metabolic health variables included all components of the metabolic syndrome, homeostatic model assessment of insulin resistance (HOMA-IR), and diagnosis of gestational diabetes mellitus (GDM).Results:Maximum milk output, mL/24 hours, ranged as follows: 30–281 in cases (n = 18), 372–801 in nested controls (n = 12), and 661–915 in external controls (n = 12). Mean breast emptying frequency in cases was not significantly different from nested or external controls. All metabolic syndrome components and HOMA-IR were significantly worse in cases as compared with both nested and external control groups (p < 0.05). There was no significant difference between the nested and external control groups for these variables. GDM prevalence was 39%, 0%, and 8%, across cases, nested control, and external control groups, respectively (chi-square p-value = 0.02).Conclusion:Results from this small case–control study identify class 2+ obesity and poor metabolic health as strong risk factors for severely low milk production. These findings should be further validated in larger prospective cohort studies designed to identify individuals at risk for metabolically driven low milk supply. In addition, clinical and qualitative research studies aimed at improving patient-centered approaches to the management of persistent low milk supply are needed.

A higher energy-adjusted Dietary Inflammatory Index is positively associated with total and visceral body fat in young male adults.

The energy-adjusted Dietary Inflammatory Index (E-DII™) has been associated with a high body mass index and markers of chronic diseases. Also, pro-inflammatory diets with a high E-DII have been positively associated with metabolic disturbances such as glucose intolerance and type II diabetes mellitus. However, it is unclear whether E-DII scores are positively associated with body fat percentage and visceral fat per se. This cross-sectional study aimed to evaluate whether the E-DII is associated with body fat content and metabolic health indicators in lean and obese young men. The present study was conducted on 59 participants, without comorbidities, not using tobacco, medication and nutritional supplements. Dietary data were obtained by 3-day food records to calculate E-DII scores based on 28 food parameters. Body composition was assessed by dual X-ray absorptiometry (DXA). Blood samples were taken to measure fasting glucose, insulin, triacylglycerols, total cholesterol, and low- and high-density lipoprotein cholesterol. An oral glucose tolerance test also was performed. Associations were determined by mixed-effects linear regression. E-DII scores ranged from -3.48 to +3.10. Energy intake was similar across E-DII tertiles. After adjusting for covariates, the highest E-DII tertile was associated with increased body fat, visceral adipose tissue and waist circumference. There was no association between E-DII scores and glycaemic parameters. In young participants, a dietary pattern with a higher E-DII (i.e., pro-inflammatory) score was associated with high body fat and markers of central adiposity assessed by DXA, regardless of body mass.

Multipollutant, longitudinal analysis of the association between urinary tungsten and incident diabetes in a rural population.

Cross-sectional studies suggest tungsten (W) exposure may be associated with diabetes. We assessed longitudinal associations between urinary W and fasting glucose, 2-hour glucose, insulin resistance (HOMA-IR), β-cell function (HOMA-β), and incident type 2 diabetes. We used data from 1,609 Hispanic and non-Hispanic White adults with 20 to 74 years of age residing in rural Colorado and participating in the San Luis Valley Diabetes Study. Urinary metal exposure values were measured at baseline and natural log-transformed. We assessed longitudinal associations between urinary W and continuous outcome measures using linear-mixed effect models and associations with incident diabetes using Fine and Gray competing risks regression models (competing event = all-cause mortality). The main adjustment set of covariates included: age, sex, ethnicity, education, smoking status, hypertension, body mass index, caloric intake, alcohol intake, and urinary creatinine levels. Secondary models were further adjusted for arsenic, cadmium, and lead exposures. We assessed whether sex or ethnicity were effect modifiers. At baseline, the median W concentration was 0.22 μg/L (interquartile range = 0.20, 0.59). In the main cross-sectional analyses, lnW levels were significantly associated with 3% higher lnHOMA-IR (95% CI = 1 to 5). In the main longitudinal models, lnW was significantly associated with 1% higher natural log-transformed fasting glucose (95% CI = <1 to 1), 3% higher natural log-transformed HOMA-IR (95% CI = 2 to 5), and 28% higher incident diabetes (subdistribution hazard ratio=1.28, 95% CI = 1.09 to 1.50). Results remained significant when further adjusting for other metals. We observed evidence for effect modification by sex and ethnicity. Urinary W was longitudinally associated with adverse metabolic health indicators.

Metabolic health, menopause, and physical activity\u2014a 4-year follow-up study

BackgroundIn women, metabolic health deteriorates after menopause, and the role of physical activity (PA) in mitigating the change is not completely understood. This study investigates the changes in indicators of metabolic health around menopause and evaluates whether PA modulates these changes.MethodsLongitudinal data of 298 women aged 48–55 years at baseline participating in the ERMA and EsmiRs studies was used. Mean follow-up time was 3.8 (SD 0.1) years. Studied indicators of metabolic health were total and android fat mass, waist circumference, waist-to-hip ratio (WHR), systolic (SBP) and diastolic (DBP) blood pressure, blood glucose, triglycerides, serum total cholesterol, and high- (HDL-C) and low-density (LDL-C) lipoprotein cholesterol. PA was assessed by accelerometers and questionnaires. The participants were categorized into three menopausal groups: PRE-PRE (pre- or perimenopausal at both timepoints, n = 56), PRE-POST (pre- or perimenopausal at baseline, postmenopausal at follow-up, n = 149), and POST-POST (postmenopausal at both timepoints, n = 93). Analyses were carried out using linear and Poisson mixed-effect models.ResultsAt baseline, PA associated directly with HDL-C and inversely with LDL-C and all body adiposity variables. An increase was observed in total (B = 1.72, 95% CI [0.16, 3.28]) and android fat mass (0.26, [0.06, 0.46]), SBP (9.37, [3.34, 15.39]), and in all blood-based biomarkers in the PRE-POST group during the follow-up. The increase tended to be smaller in the PRE-PRE and POST-POST groups compared to the PRE-POST group, except for SBP. The change in PA associated inversely with the change in SBP (−2.40, [−4.34, −0.46]) and directly with the change in WHR (0.72, [0.05, 1.38]).ConclusionsIn middle-aged women, menopause may accelerate the changes in multiple indicators of metabolic health. PA associates with healthier blood lipid profile and body composition in middle-aged women but does not seem to modulate the changes in most of the studied metabolic health indicators during the menopausal transition.

Late-Pregnancy Fetal Hypoxia Is Associated With Altered Glucose Metabolism and Adiposity in Young Adult Offspring of Women With Type 1 Diabetes.

ObjectiveTo investigate associations between exposure to fetal hypoxia and indicators of metabolic health in young adult offspring of women with type 1 diabetes (OT1D).Methods156 OT1D born between 7/1995 and 12/2000 at Helsinki University Hospital, Finland, were invited for follow-up between 3/2019 and 11/2019. A control group of 442 adults born from non-diabetic pregnancies, matched for date and place of birth, was obtained from the Finnish Medical Birth Register. In total, 58 OT1D and 86 controls agreed to participate. All OT1D had amniotic fluid (AF) sampled for erythropoietin (EPO) measurement within two days before delivery in order to diagnose fetal hypoxia. In total, 29 OTID had an AF EPO concentration <14.0 mU/l, defined as normal, and were categorized into the low EPO (L-EPO) group. The remaining 29 OT1D had AF EPO ≥14.0 mU/ml, defined as fetal hypoxia, and were categorized into the high EPO (H-EPO) group. At the age of 18-23 years, participants underwent a 2-h 75g oral glucose tolerance test (OGTT) in addition to height, weight, waist circumference, body composition, blood pressure, HbA1c, cholesterol, triglyceride, high-sensitivity CRP and leisure-time physical activity measurements.ResultsTwo OT1D were diagnosed with diabetes and excluded from further analyses. At young adult age, OT1D in the H-EPO group had a higher BMI than those in the L-EPO group. In addition, among female participants, waist circumference and body fat percentage were highest in the H-EPO group. In the OGTTs, the mean (SD) 2-h post-load plasma glucose (mmol/L) was higher in the H-EPO [6.50 (2.11)] than in the L-EPO [5.21 (1.10)] or control [5.67 (1.48)] offspring (p=0.009). AF EPO concentrations correlated positively with 2-h post-load plasma glucose [r=0.35 (95% CI: 0.07 to 0.62)] and serum insulin [r=0.44 (95% CI: 0.14 to 0.69)] concentrations, even after adjusting for maternal BMI, birth weight z-score, gestational age at birth and adult BMI. Control, L-EPO and H-EPO groups did not differ with regards to other assessed parameters.ConclusionsHigh AF EPO concentrations in late pregnancy, indicating fetal hypoxia, are associated with increased adiposity and elevated post-load glucose and insulin concentrations in young adult OT1D.

Short-term ozone exposure and metabolic status in metabolically healthy obese and normal-weight young adults: A viewpoint of inflammatory pathways

Unhealthy metabolic status increases risks of cardiovascular and other diseases. This study aims to explore whether there is a link between O3 and metabolic health indicators through a viewpoint of inflammatory pathways. 49 metabolically healthy normal-weight (MH-NW) and 39 metabolically healthy obese (MHO) young adults aged 18–26 years were recruited from a panel study with three visits. O3 exposure were estimated based on fixed-site environmental monitoring data and time-activity diary for each participant. Compared to MH-NW people, MHO people were more susceptible to the adverse effects on metabolic status, including blood pressure, glucose, and lipid indicators when exposed to O3. For instance, O3 exposure was associated with significant decreases in high-density lipoprotein cholesterol (HDL-C), and increases in C-peptide and low-density lipoprotein cholesterol (LDL-C) among MHO people, while only weaker changes in HDL-C and LDL-C among MH-NW people. Mediation analyses indicated that leptin mediated the metabolic health effects in both groups, while eosinophils and MCP-1 were also important mediating factors for the MHO people. Although both with a metabolically healthy status, compared to normal-weight people, obese people might be more susceptible to the negative effects of O3 on metabolic status, possibly through inflammatory indicators such as leptin, eosinophils, and MCP-1.