Low Fasting Glucose Research Articles

Lean Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-Alcoholic Fatty Liver Disease (NAFLD) is a condition that can develop into advanced liver disease. The NAFLD spectrum includes simple steatosis, non-alcoholic steatohepatitis (NASH), liver fibrosis, and liver cirrhosis to hepatocellular carcinoma. One of the underlying pathophysiologies is insulin resistance found in metabolic syndrome. People with metabolic syndrome are not always obese, and NAFLD can also be found in this group, known as lean NAFLD, which has different metabolic characteristics. Metabolic characteristics of lean NAFLD include high levels of transaminases and insulin, low insulin sensitivity, low fasting glucose, low necroinflammatory activity, and liver fibrosis. Some related factors are methionine and choline deficiency, excessive acyl-coA expression, and PNPLA3 gene polymorphism. Lean NAFLD is an interesting topic to discuss because practitioners' awareness of lean NAFLD is lower compared to obese patients. NAFLD is a risk factor for chronic diseases such as cardiovascular disease, kidney disease, colorectal, atrial fibrillation, and hypothyroidism, so it is essential to be recognized by clinicians. To date, there are no guidelines or recommendations that discuss specific treatments in this lean NAFLD population. Â

The sweet spot: fasting glucose, cardiovascular disease, and mortality in older adults with diabetes: a nationwide population-based study

BackgroundGrowing evidences shows that fasting glucose target should be different according to their health condition in older adults with diabetes. However, there are limited data regarding the relationship between fasting glucose level and health outcomes in Korean older people with diabetes. We aimed to examine the association of fasting glucose with mortality and cardiovascular events in Korean older adults with type 2 diabetes.MethodsFrom the Korean National Health Insurance System, 227,938 subjects (aged ≥ 65 years) with type 2 diabetes but no history of cardiovascular events (myocardial infarction or stroke) who underwent ≥ 2 health examinations from 2009 to 2010 and who were followed up until 2017 were identified. The primary exposure variable was the mean fasting glucose level. We estimated the relationship between the baseline fasting glucose level and incidences of all-cause death and cardiovascular events. Comorbidity load was assessed using the Charlson comorbidity index.ResultsFasting glucose levels and all-cause mortality risk showed a J-shaped relationship regardless of sex and number of comorbidities. Fasting glucose levels associated with the lowest mortality and cardiovascular events were 110–124 and 95–124 mg/dL, respectively. Stratified analysis by comorbidity load using the Charlson comorbidity index revealed higher optimal fasting glucose levels for the lowest cardiovascular events in subjects with Charlson comorbidity index ≥ 3 than in those with Charlson comorbidity index ≤ 2 (119 vs. 112 mg/dL, P = 0.04).ConclusionsJ-shaped relationship existed between fasting glucose and all-cause mortality and cardiovascular events in Korean older adults with diabetes. We identified that fasting glucose levels associated with the lowest mortality and cardiovascular events were 110–124 and 95–124 mg/dL respectively. Increased risk of cardiovascular events with low fasting glucose level (< 95 mg/dL) was noted, especially in patients with high comorbidity. These findings suggested that less stringent targets of fasting glucose may be beneficial especially in older adults with multiple comorbidities.

Dynamic Phenotypes and Molecular Mechanisms to Understand the Pathogenesis of Diabetic Nephropathy in Two Widely Used Animal Models of Type 2 Diabetes Mellitus.

ObjectiveWe aimed to characterize the pathogenesis of diabetic nephropathy (DN) in two commonly used type 2 diabetes mellitus (T2DM) animal models and explore the preliminary molecular mechanisms underlying DN in two models.MethodsTo verify the effect of hyperglycemia on renal tissue, we observed the cell growth inhibition rate by adding different concentration of glucose to cell supernatant. After that, a chemically-induced T2DM model was established by administering streptozotocin (STZ) to Sprague Dawley (SD) rats in combination with high fat feeding. In addition, a spontaneous T2DM model was established by feeding 8 weeks old KK-Ay mice a high-fat diet during a period of over 20 weeks. Animal body weight, fasting blood glucose (FBG), insulin tolerance, lipid metabolism, renal function, and renal pathology were periodically measured (once every 2 or 4 weeks) over a duration of 20 weeks. At the 12th week, an Affymetrix gene chip assay was performed on the renal tissues extracted from the T2DM animal models and control animals. Through screening for the differentially expressed genes, some key genes were selected for PCR validation.ResultsHigh level of glucose could inhibit the growth of kidney cells. Besides, KK-Ay mice were found to have high FBG and abnormal insulin tolerance. Renal dysfunction and pathology were observed at the 4th week following the start of model creation, which increased in severity over the length of the experiment. The T2DM SD rats also showed high FBG, abnormal glucose tolerance and abnormal lipid metabolism, but the renal function and renal pathology changed only slightly within 20 weeks. Gene profiling in animal kidneys and subsequent analyses and validation revealed differentially expressed genes and enriched pathways in DN.ConclusionKK-Ay mice with both high fasting glucose and insulin resistance were more likely to develop diabetic nephropathy than STZ-induced diabetic SD rats with low fasting glucose or only insulin resistance. The KK-Ay mice model showed earlier onset of the typical pathological characteristics associated with T2DM and obvious renal lesions suggestive of kidney damage.

Metabolic Syndrome and Related Factors in Chinese Children and Adolescents: Analysis from a Chinese National Study.

Aims: Metabolic syndrome (MetS) has become a worldwide epidemic; however, few studies have described its status in Chinese children. This study aimed to estimate MetS status and its associations with geography, economic development, birth weight, and parental education of Chinese children and adolescents.Methods: Data were derived from 15,045 participants aged 7–18 years across seven Chinese provinces. Physical measurement and blood tests were conducted to assess the five classical MetS components described by the International Diabetes Federation, including abdominal obesity (the essential component), high blood pressure, low high-density cholesterol (HDL-C), high triglyceride, and elevated fasting glucose (FG). Logistic regression was adopted to explore possible associations between MetS and other factors.Results: Overall, MetS prevalence was 2.3%, higher in males (2.8% vs. 1.7% in females), northern regions (3.1%), more developed regions (2.9%), and older participants (aged 16–18 years) (P < 0.05 for all). Among the five MetS components, abdominal obesity and low HDL-C level were most prevalent (21.8% and 14.4%), and 35.9% of the participants had at least one component. In logistic regression, MetS itself did not correlate with birth weight or parental education. High birth weight was positively correlated with abdominal obesity (odds ratio, 1.48) butnegatively associated with elevated FG (odds ratio, 0.49).Concusions: MetS itself was not common in Chinese children and adolescents, whereas its certain components were far more prevalent. Children from North China, more-developed areas, and at an older age were more likely to develop MetS. Strategies designed to prevent pediatric MetS in China should focus on prevalent components as well as its geographic and economic development predilections.

Low fasting glucose and future risks of major adverse outcomes in people without baseline diabetes or cardiovascular disease: a systematic review and meta-analysis

ObjectiveTo investigate the link between low fasting blood glucose levels and all-cause mortality and cardiovascular outcomes among people without baseline diabetes or cardiovascular disease.DesignSystematic review and meta-analysis.Data sourcesPubMed and Embase...

Insulin Resistance and Cardiovascular Risks in Different Groups of Hemodialysis Patients: A Multicenter Study.

Background To investigate the association between insulin resistance (IR) and cardiovascular disease (CVD) risks among hemodialysis patients. Methods We conducted a cross-sectional study between 2013 and 2017, on 384 hemodialysis patients from seven hospital-based-dialysis centers. HOMA-IR is classified according to median value. The CVD risks were defined by the K/DOQI Guidelines. Logistic regression analysis was used. Results Patients' age was 60.9 ± 11.8, 58.1% men, and 40.3% overweight/obese. The median of HOMA-IR was 5.4, 82.8% high systolic blood pressure, and 85.7% hyperhomocysteinemia. In multivariate analysis, IR was significantly associated with higher odds of low high-density lipoprotein cholesterol, high triglyceride, and impaired fasting glucose in groups of normal weight, overweight/obese, nondiabetes, diabetes, and overall sample. IR linked with elevated high-sensitive C-reactive protein in normal weight patients (odd ratio, OR=2.21, 95% confidence interval, 1.16-4.22, p < .05), with hypoalbuminemia in normal weight patients (OR=8.31, 95% CI, 2.35-29.37, p < .01), in nondiabetes patients (OR=6.59, 95% CI, 1.81-23.95, p < .01), and overall sample (OR=3.07, 1.51-6.23, p < .01). Conclusions The level of IR and prevalence of CVD risks were high in hemodialysis patients. IR was independently associated with CVD risks.

Cardiac autonomic function and its association with cardiometabolic disease risk factors in Black South African children.

This study evaluated the associations between cardiac autonomic nervous system (ANS) activity and cardiometabolic disease (CMD) risk factors among black South African children. The participants included 34 black South African children (11.85 ± 0.89 y). CMD risk factors included waist circumference (WC), hip circumference (HC), body mass index z-score (BMI z-score), blood pressure (SBP, DBP), total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), fasting glucose (FG), fasting insulin (FINS), and vessel stiffness index (SI). Heart rate variability was used to quantify cardiac ANS activity. lnRMSSD, pNN50 and lnSD1 were inversely associated with FINS (r = -0.33, p = 0.05; r = -0.36, p = 0.03; r = -0.41, p = 0.01), WC (r = -0.45, p = 0.01; r = -0.39, p = 0.02; r = -0.45, p = 0.01), and HC (r = -0.41, p = 0.01; r = -0.36, p = 0.03; r = -0.43, p = 0.01). HDL was positively associated with lnRMSSD (r = 0.37; p = 0.03) and lnSD1 (r = 0.37; p = 0.03) while, LDL was negatively associated with HF (r = -0.41; p = 0.01). Regression analysis identified WC as the primary predictor for parasympathetic modulation in time domain (lnRMSSD: r2 = 0.21, p = 0.01; pNN50: r2 = 0.18, p = 0.01) and non-linear domain (lnSD1: r2 = 0.21, p = 0.01). Elevated resting parasympathetic activity in children is associated with lower CMD risk factors and an elevation in the protective HDL.

Association of Low Fasting Glucose and HbA1c With Cardiovascular Disease and Mortality: The MESA Study.

Trials of intensive glucose control have not improved cardiovascular disease (CVD) risk in populations with type 2 diabetes; however, in the general population, reports are inconsistent about the effects of maintaining lower glucose levels. Some speculate that low glycemic values are associated with increased glycemic variability, which is in turn associated with higher CVD risk. It has also been suggested that fasting glucose and hemoglobin A1c (HbA1c) in the lower ranges have a different relationship with CVD and mortality. In 4990 participants from the Multi-Ethnic Study of Atherosclerosis, we used logistic regression to investigate associations of low fasting glucose (<80 mg/dL) and HbA1c (<5.0%) from baseline and averaged across follow-up with incident CVD and mortality over 13 years. We used normal glycemic ranges (80 to <100 mg/dL and 5.0 to <5.7%) as references and analyzed glycemic levels with visit-matched covariates. We adjusted for potential confounding by age, sex, race/ethnicity, education, income, smoking status, body mass index, total cholesterol level, cholesterol medications, high-density lipoprotein cholesterol, and hypertension. Low baseline glucose and HbA1c were positively, but not significantly, associated with mortality, whereas low average fasting glucose and HbA1c were strongly and significantly associated with incident CVD [glucose OR, 2.04 (95% CI, 1.38-3.00); HbA1c OR, 2.01 (95% CI, 1.58-2.55)] and mortality [glucose OR, 1.93 (95% CI, 1.33-2.79); HbA1c OR, 2.51 (95% CI, 2.00-3.15)]. These results were not due to type 2 diabetes or medication use. Glucose variability did not explain CVD risk beyond average glucose levels. Chronic low fasting glucose and HbA1c may be better indicators of risk than a single low measurement.

C679X loss-of-function PCSK9 variant is associated with lower fasting glucose in black South African adolescents: Birth to Twenty Plus Cohort

AimTo evaluate the association between loss-of-function (LOF) PCSK9 variants (A433T/rs28362263 and C679X/rs28362286) and biomarkers of cardiometabolic risk, specifically fasting glucose and low density lipoprotein cholesterol (LDL-C) concentrations. MethodsOur study comprised 757 male and female black South African adolescents (mean age 18.0 ± 0.5 years) who are part of the Birth to Twenty Plus Cohort and had been genotyped for the two above-mentioned variants. Anthropometric measures were completed and fasting plasma glucose and lipid analysis were performed using standard procedures. ResultsThe median and interquartile range of fasting glucose and LDL-C for the whole group were 4.60 (4.36–4.88) mmol/L and 1.67 (1.25–2.14) mmol/L, respectively. After adjusting for sex, association between the biomarkers and A443T was not significant. However, C679X carriers displayed 0.30 [95% CI (−0.57, −0.02); p = 0.035] mmol/L lower fasting glucose and 0.50 [95% CI (−0.74, −0.26); p < 0.001) mmol/L lower LDL-C concentrations compared to non-carriers. ConclusionsOur results indicate for the first that the C679X variants associated with low fasting glucose levels during adolescents as had been known for LDL-C. In view that a similar finding was reported in older black South African adults, therefore, the correlation of lower fasting glucose and LDL-C levels with C679X is observed from an early age to adulthood.

The association between fasting plasma glucose and all-cause and cause-specific mortality by gender: The rural Chinese cohort study.

To evaluate the association between fasting plasma glucose (FPG) and mortality by gender. A total of 17248 eligible participants from a rural Chinese prospective cohort population were included. The same questionnaire interview and anthropometric and laboratory measurements were performed at both baseline (2007-2008) and follow-up (2013-2014). Participants were classified according to baseline FPG and diabetic status by sex. Restricted cubic splines and Cox proportional-hazards regression models, estimating hazard ratio (HR) and 95% confidence interval (CI), were used to assess the FPG-mortality relation. During the 6-year follow-up, 618 men and 489 women died. The FPG-mortality relation was J shaped for both sexes. For men, risk of all-cause and noncardiovascular disease (CVD)/noncancer mortality was greater with low fasting glucose (LFG) than with normal fasting glucose (adjusted HR [aHR] 1.60; 95% CI, 1.05-2.43; and aHR 2.16; 95% CI, 1.15-4.05). Men with diabetes mellitus (DM) showed increased risk of all-cause (aHR 2.04; 95% CI, 1.60-2.60), CVD (aHR 1.98; 95% CI, 1.36-2.89), and non-CVD/noncancer mortality (aHR 2.62; 95% CI, 1.76-3.91). Men with impaired fasting glucose (IFG) had borderline risk of CVD mortality (aHR 1.34; 95% CI, 1.00-1.79). Women with LFG had increased risk of non-CVD/noncancer mortality (aHR 2.27; 95% CI, 1.04-4.95), and women with DM had increased risk of all-cause (aHR 1.73; 95% CI, 1.35-2.23), CVD (aHR 1.76; 95% CI, 1.24-2.50), and non-CVD/noncancer mortality (aHR 1.97; 95% CI, 1.27-3.08). LFG is positively associated with all-cause mortality risk in rural Chinese men but not in women.

Fasting glucose and its association with 20-year all-cause and cause-specific mortality in Chinese general population

ObjectiveThe aim of this study was to explore the relationship between fasting glucose levels and all-cause and cause-specific mortality in Chinese population. MethodsThe role of fasting blood glucose levels as a predictor of all-cause and cause-specific mortality was estimated in 9930 participants from four Chinese general populations with a 20-year follow-up. Multivariate Cox proportional hazard models were used to identify the relationship between fasting glucose and mortality. ResultsThere were 1471 deaths after a median follow-up of 20.2 years (a total of 187,374 person-years), including 310 cardiovascular deaths, 581 cancer deaths, and 580 other-cause deaths. After adjustment for age, sex, urban or rural, northern or southern of China, types of work, education level, physical exercise, smoking status, drinking status, body mass index, systolic blood pressure, and serum total cholesterol at baseline, the hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in the fasting blood glucose categories of <60, 60–69, 70–79, 90–99, 100–109, 110–125, and ≥126 mg/dl were 1.38 (1.04–1.84), 1.20 (1.01–1.43), 1.18 (1.03–1.36), 1.18 (0.99–1.41), 1.48 (1.16–1.88), 1.17 (0.84–1.62), and 2.23 (1.72–2.90), respectively, in contrast to the reference group (80–89 mg/dl). The HRs and 95% CIs for cardiovascular disease mortality in these groups were 2.58 (1.44–4.61), 1.41 (0.95–2.10), 1.56 (1.15–2.11), 1.29 (0.88–1.89), 1.36 (0.78–2.37), 1.05 (0.52–2.11), and 2.73 (1.64–4.56), respectively. ConclusionsBoth low and high fasting glucose were significantly associated with increased risk of all-cause and cardiovascular mortality in Chinese general population.

The relationship between arterial stiffness and maximal oxygen consumption in healthy young adults

ObjectiveArterial stiffness is associated with an increased risk of cardiovascular diseases in various populations. There was little research on the relationship between arterial stiffness and maximal aerobic capacity (VO2max) in healthy young adults. The aim of this study was to investigate the relationship between VO2max and arterial stiffness in young adults. MethodsThe subjects were 13 men and 10 women with mean age of 22.9 ± 0.7, 23.6 ± 0.4 years, respectively. Height, weight, body mass index, body fat (%), waist to hip ratio, total/high density lipoprotein (HDL)/low density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, blood pressure, heart rate, glycated hemoglobin and blood lactate were measured. In addition, peripheral arterial stiffness was assessed by measuring brachial-ankle pulse wave velocity (baPWV) and VO2max was determined using graded exercise test. ResultsVO2max had no significant correlation with baPWV (r = 0.2, p = 0.2). Total cholesterol correlated significantly to variables such as HDL (r = 0.6, p = 0.0015) and LDL cholesterol (r = −0.6, p = 0.0018). VO2max had a significant association with triglyceride (r = −0.5, p = 0.0033). ConclusionsThis study suggests that there is no relationship between arterial stiffness and aerobic capacity in healthy young adults.

The Effect of Roux-en-Y Reconstruction on Type 2 Diabetes in the Early Postoperative Period.

The aim of this study was to investigate the effect of Roux-en-Y (RY) reconstruction on type 2 diabetes with gastric cancer in the early postoperative period. A total of 44 patients with gastric cancer with type 2 diabetes who underwent total gastrectomy (TG) or distal gastrectomy (DG) with Roux-en-Y reconstruction or DG with Bilroth I were enrolled. All three groups had their fasting glucose and daily insulin dose recorded preoperatively, on day 2 postoperatively (POD2) and at discharge. The TG group showed low fasting glucose and daily insulin dose on POD2 compared to their preoperative state. On discharge, the fasting glucose and daily insulin dose were significantly lower in both TG and DG Roux-en-Y groups than preoperatively. Roux-en-Y reconstruction showed early improvement of type 2 diabetes regardless of any body weight loss. The effect of Roux-en-Y reconstruction in TG on type 2 diabetes was more remarkable than that of DG.

Abstract WP167: Low Fasting Blood Glucose and Risks of Vascular and Mortality Outcomes in General Population: A Systematic Review and Meta-Analysis

Background and Purpose: Although low fasting blood glucose may imply poor nutrition status or hyperinsulinemia, whether low fasting blood glucose level increases future risks of stroke, cardiovascular disease, and mortality remain unsettled. We conducted a meta-analysis to examine the effect of low fasting blood glucose on subsequent major vascular outcomes in general populations without previous cardiovascular disease history. Methods: We searched PubMed and EMBASE from 1966 to June 2017. We included prospective cohort studies, which evaluated the effects of low and normal fasting glucose levels (4.7-5.5 mmol/L) on future risks of stroke, coronary heart disease, cardiovascular disease, and mortality. We analyzed data with cutoff levels of low fasting glucose level &lt; 4.6 mmol/L and 4.0 mmol/L, respectively. Hazard ratio and 95 % confidence intervals were used to measure association between low fasting glucose levels and the risks of outcomes using random effect models. Results: We included 10 articles (consisting of 129 prospective cohort studies) that met our criteria; 3,277,497 participants were included in current meta-analysis. Comparing with the normal glucose group, low fasting blood glucose defined as &lt; 4.6 mmol/L was not associated with the risk of stroke (adjusted HR 1.02, 0.99 to 1.06) or coronary heart disease (adjusted HR 1.02, 0.96 to 1.08), but was associated with an increased risk of all-cause mortality (adjusted HR 1.36, 1.06 to 1.75) (Fig 1 A), and total cardiovascular events (adjusted HR 1.03, 1.02 to 1.05). Using &lt; 4.0 mmol/L as a cutoff level for low fasting blood glucose showed similar results (Fig 1B). Conclusions: Low fasting blood glucose is not associated with increased risk of stroke or coronary heart disease, but is associated with an increased all-cause mortality in the general population.

Low normal fasting glucose and risk of accidental death in Korean adults: A prospective cohort study

AimThis study aimed to prospectively examine whether low normal glucose levels and hypoglycaemia are associated with increased mortality due to external causes, especially unintentional accidents. MethodsA total of 345,318 normoglycaemic Korean adults who had undergone health examinations during 2002–2003 were followed-up to 2013. To avoid potential biases related to glucose-lowering medication use, those with known diabetes or hyperglycaemia were excluded. ResultsDuring 3.6 million person-years of follow-up, 1293 participants died because of unintentional accidents. Hazard ratios (HRs) for these accidental deaths were 1.26 (95% CI: 1.11–1.42), 1.60 (1.21–2.11) and 3.07 (1.37–6.85) for fasting serum glucose (FSG) levels of 70–79, 55–69 and <55mg/dL (3.9–4.4, 3.05–3.83 and <3.05mmol/L), respectively, compared with 80–99mg/dL (4.44–5.5mmol/L). FSG levels<80mg/dL were associated with an approximately 30% higher mortality due to accidents: specifically, 40% were non-fall-related injury; 50% were automobile-related; and 80% were motorcycle-related. The associations were weak (approximately 10% higher mortality, with P>0.05 for each cause) for deaths due to traffic accidents (pedestrians, pedal cyclists), falls, intentional self-harm and physical assault. The population attributable risks for FSG levels <80mg/dL were 10% (95% CI: 2–18%) for non-fall-related injury, 11% (6–17%) for car accidents and 17% (6–27%) for motorcycle accidents. ConclusionFSG levels of 70–79mg/dL (3.9–4.4mmol/L) as well as <70mg/dL are risk factors for accidental death. Appropriate management of the impact of FSG levels <80mg/dL might reduce unintended deaths due to non-fall-related injury, and automobile and motorcycle accidents, by ≥10%.

Fasting glucose and risk of colorectal cancer in the Korean Multi-center Cancer Cohort.

Previous cohort studies have demonstrated a positive association between diabetes mellitus (DM) and colorectal cancer (CRC). However, there are few comparisons between DM groups categorized by fasting glucose level. This study examined associations between diabetes as defined by fasting glucose level and self-reported history of DM and CRC risk among Korean adults. Data from the Korean Multi-center Cancer Cohort between 1993 and 2005 were analyzed. The study population comprised 14,570 participants aged 20 years or older. Participants were followed until December 31, 2012 (median follow-up: 11.9 years). Among participants with high fasting glucose (≥126mg/dL), the risk of developing CRC was significantly higher (HR: 1.51 [1.02–2.25]) than among participants with low fasting glucose (<126mg/dL). Risk was not significantly higher among participants with self-reported history of DM (HR: 1.34 [0.78–2.31]). When both fasting glucose and history of DM were considered together, the risk of CRC among participants with both high fasting glucose and history of DM was 54% (HR: 1.54 [0.97–2.43]), and the risk of CRC among participants with high fasting glucose and no history of DM was 50% (HR: 1.50 [0.73–3.05]). When the first 5 years of follow-up were excluded, among participants with high fasting glucose, the risk of developing CRC was significantly higher (HR: 1.61 [1.02–2.56]) than among participants with low fasting glucose. Risk of CRC was also significantly higher among participants with high fasting glucose and no history of DM (HR: 1.69 [1.01–2.84]). High fasting glucose and self-reported history of DM were associated with increased risk of CRC in this Korean population.

Effects of β‐Glucan Content and Pearling of Barley in Diet‐Induced Obese Mice

The effects of the β‐glucan content and pearling of barley on abdominal obesity and the proinflammatory state were investigated in diet‐induced obese mice. Male C57BL/6J mice were randomly divided into four groups and fed either a high‐fat diet containing high‐β‐glucan barley (Beau Fiber [BF]) or a high‐fat diet containing β‐glucan‐free barley (Shikoku‐hadaka 84(bgl) [BGL]) as whole grain flour or 60% pearled flour for 12 weeks. The weights of mesenteric fat, serum total and low density lipoprotein cholesterol levels, serum insulin and fasting glucose levels, oral glucose tolerance test results, and messenger RNA (mRNA) expression of proinflammatory markers in epididymal fat in both BF groups were significantly lower than those of both BGL groups. The abundance of Bacteroides in both BF groups was significantly higher than that in both BGL groups, whereas the abundance of Clostridium clusters in both BF groups was significantly lower than that in both BGL groups. No significant differences between the whole grain and pearled flours were observed. These results suggest that high‐β‐glucan barley attenuates the progression of abdominal obesity and the proinflammatory state in diet‐induced obese mice compared with β‐glucan‐free barley, possibly by modifying insulin secretion and the microbiota.

Maternal low intensity physical exercise prevents obesity in offspring rats exposed to early overnutrition

Low intensity exercise during pregnancy and lactation may create a protective effect against the development of obesity in offspring exposed to overnutrition in early life. To test these hypotheses, pregnant rats were randomly assigned into 2 groups: Sedentary and Exercised, low intensity, on a rodent treadmill at 30% VO2Max /30-minute/session/3x/week throughout pregnancy and the lactation. Male offspring were raised in small litters (SL, 3 pups/dam) and normal litters (NL, 9 pups/dam) as models of early overnutrition and normal feed, respectively. Exercised mothers showed low mesenteric fat pad stores and fasting glucose and improved glucose-insulin tolerance, VO2max during lactation and sympathetic activity. Moreover, the breast milk contained elevated levels of insulin. In addition, SL of sedentary mothers presented metabolic dysfunction and glucose and insulin intolerance and were hyperglycemic and hyperinsulinemic in adulthood. SL of exercised mothers showed lower fat tissue accretion and improvements in glucose tolerance, insulin sensitivity, insulinemia and glycemia. The results suggest that maternal exercise during the perinatal period can have a possible reprogramming effect to prevent metabolic dysfunction in adult rat offspring exposed to early overnutrition, which may be associated with the improvement in maternal health caused by exercise.

Association between glycosylated hemoglobin and non-alcoholic fatty liver disease in health examination population

To investigate associations between glycosylated hemoglobin (HbA1c) levels and non-alcoholic fatty liver disease (NAFLD) in population who underwent periodic heath examination. Methods: A total of 912 subjects were selected from the health examination adults in University of Hong Kong Shenzhen Hospital from June to November 2013, and they were assigned into a NAFLD group, an else hepatic disease group, and a control group. The physical examination results of these subjects were analyzed retrospectively. Results: The prevalence of NAFLD was 29.7%. The related factors such as age, body mass index, and the levels of systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting glucose, HbA1c and alanine aminotransferase in the NAFLD group were higher than those in the else hepatic disease group and the control group (P<0.05). Aspartate aminotransferase levels in the NAFLD group were higher than those in the control group (P<0.05). High density lipoprotein cholesterol levels in the NAFLD group were lower than those in the else hepatic disease group and the control group (P<0.05). According to the quartile of HbA1c level, these subjects were divided into 4 groups, Q1, Q2, Q3, and Q4, and the prevalence of NAFLD in the Q1,Q2, Q3, and Q4 were 17.5%, 21.5%, 31%, and 59.4%, respectively. The prevalence of NAFLD increased along with the increase in the level of HbA1c (χ2=100.092, P<0.05). Logistic regression analysis showed that the risk factor for NAFLD was increased in the subjects of Q4 as compared with the subjects of Q1 after adjusting for the related factors including age, gender, body mass index, etc. Conclusion: There is a positive correlation between the prevalence of NAFLD and HbA1c level, and the risk of NAFLD increases with the elevating level of HbA1c. High HbA1c level is an independent risk factor for NAFLD. Thus it should be listed as a routine medical test in the health examination.

Abstract P051: Association of Subclinical Hypoglycemia with Incident Cardiovascular Disease and All-cause Mortality: The Multi-Ethnic Study of Atherosclerosis

Trials of intensive glucose control have not improved cardiovascular disease (CVD) risk in type 2 diabetes; however data are inconsistent about the effects of maintaining below normal glucose levels in the general population. Further, it has been suggested that fasting glucose and HbA1c in the lower ranges have a different relationship with CVD and mortality. In 5992 participants from the Multi-Ethnic Study of Atherosclerosis, free of CVD at baseline, we used logistic regression to investigate the associations of low fasting glucose (&lt;80mg/dL) and HbA1c (&lt;5.0%), from baseline and averaged across follow-up over 13 years, with incident CVD and mortality. We used the normal range (80 to &lt;100mg/dL and 5.0 to &lt;5.7%) as reference. We excluded participants with diabetes at baseline from the low, normal, and impaired groups at baseline, and excluded participants with diabetes at any visit from those groups for averaged values. We matched covariates to the visit of glycemic data collection. Participants with low fasting glucose were more likely to be younger, female, Asian, use glucose lowering medication, have lower BMI and be normotensive. Those with low HbA1c were more likely to be younger, Asian or Hispanic, and have higher income at baseline. Adjusted for age, sex, race/ethnicity, education, and income, glucose and HbA1c in the impaired (100 to &lt;126mg/dL and 5.7 to &lt;6.5%) and diabetic ranges (≥126mg/dL and ≥6.5%) at baseline were significantly associated with increased CVD and mortality. Low baseline glucose and low baseline HbA1c were positively, but not significantly, associated with mortality; while low average glucose and low average HbA1c were both strongly and significantly associated with increased risk of mortality (Figure). The relationships between fasting glucose and HbA1c with mortality are J-shaped at baseline, but strongly and significantly U-shaped when average levels are used. Consistently low fasting glucose or HbA1c may be better markers for risk from subclinical hypoglycemia than a single low measurement.