Non-diabetic Participants Research Articles

Biomarkers of Covert Acid Stress in Patients with Chronic Kidney Disease: A Cross-Sectional Study

Introduction: Like metabolic acidosis, earlier stages of acid (H+) stress, including an ongoing H+ challenge in the form of dietary H+, without or with steady-state H+ accumulation but with normal plasma total CO2 (PTCO2) (the latter state known as eubicarbonatemic acidosis), are associated with augmented progression of chronic kidney disease (CKD), but diagnosis of this covert H+ stress is clinically problematic. Prior published studies to identify clinically practical biomarkers of covert H+ stress did not include assessments of either dietary H+ or H+ retention. Methods: We tested plasma pH (PpH), 8-h urine excretion of citrate (UcitV) or ammonium (UNH4+V) as biomarkers of dietary H+ assessed as potential renal acid load (PRAL), and of steady-state H+ retention by comparing observed to expected PTCO2 increase 2 h after an oral NaHCO3 bolus. We recruited 313 non-diabetic participants with PTCO2 ≥ 22 mM to exclude participants with metabolic acidosis and with eGFR (mean [SD], mL/min/1.73 m2) stages G1 (n = 62, 99.2 [7.3]), G2 (n = 167, 73.8 [6.3]), and G3 (n = 84, 39.9 [6.7]). We performed linear regressions (LR) between H+ retention or PRAL (dependent variables) and PpH, UcitV, or UNH4+V (independent variables) after adjusting for eGFR. Results: Steady-state H+ retention (mean [SD], mmol) increased with stage (G1 = 3.8 [12.5], G2 = 18.2 [12.4], and G3 = 25.6 [9.0]). PpH was not significantly associated with PRAL in any group, and its association with H+ retention was significant only for G3 (p < 0.01). UcitV association with PRAL was significant only for G1 (p < 0.01) but not for G2 (p = 0.65) or G3 (p = 0.11). UcitV association with H+ retention was negative for both G2 (p < 0.01) and G3 (p < 0.01) but was not significant for G1 (p = 0.50). Adding UNH4+V to UcitV as a regressor for H+ retention increased r2 only marginally for G2 (0.61–0.63) and G3 (0.75–0.79). UNH4+V association with PRAL was positive (p < 0.01) for G1 and G2 but was not significant for G3 (p = 0.46). UNH4+V association with H+ retention was significant for both G2 (p < 0.04) and G3 (p < 0.01) but diverged directionally, being positive for G2 but negative for G3. Discussion: Among patients with CKD at risk for covert H+ stress, lower UcitV better identified eubicarbonatemic acidosis than UNH4+V because the UNH4+V versus H+ retention relationship diverged between G2 and G3. Neither test identified eubicarbonatemic acidosis with certainty, indicating need for further work to establish a clinically useful test. On the other hand, UNH4+V had better utility identifying increased dietary H+ assessed as PRAL in G1 and G2.

Pro-Inflammatory diet accounts for higher prevalence of retinopathy in diabetes participants rather than normal glucose and prediabetes: Results from NHANES, 2005-2008.

Retinopathy is a chronic inflammatory disease whose prognosis could be improved with dietary interventions. However, the association between a pro-inflammatory diet and the prevalence of retinopathy has not been fully elucidated. We assess the association between the dietary inflammatory index (DII), which is a comprehensive index determining inflammatory potential derived from food parameters according to literature, and the prevalence of retinopathy based on the data from the National Health and Nutritional Examination Survey (NHANES) 2005-2008 involving 2,403 participants. Energy-adjusted DII (E-DII) was not related to the occurrence of retinopathy in the general, non-diabetic, or middle-aged participants. In the diabetic and aged participants, one unit increment of E-DII accounted for 14 and 15% higher the prevalence of retinopathy respectively. The highest E-DII group had a 78 and 79% higher prevalence of retinopathy than the lowest group respectively. After adjusting for several covariables, the highest E-DII group was still associated with a 68% increase in retinopathy in diabetic patients. These results suggest that E-DII is positively associated with the prevalence of diabetic retinopathy among diabetic patients.

Musculoskeletal Characteristics among Diabetic and NonDiabetic Patients Attended at Centre for the Rehabilitation of the Paralyzed (CRP)

Objectives: This study was aimed to find out the musculoskeletal characteristics, behavioral risk factors and association of the musculoskeletal characteristics of diabetic and non-diabetic population. Methods: A descriptive type of cross sectional study of 230 participants was conducted where 68 participants were diabetic and 162 were non-diabetic. The sample was selected by using convenient sampling technique. Data was collected from the participants through face to face interview The structured questionnaire was made using Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Results: The study result shows that, among diabetic and non-diabetic participants 57.4% and 56.2% were female and highest number of participants, 26.5% diabetic and 27.2% non-diabetic participants correspondingly were in the age range of 31-40 and 41-50 years. Nearly half of the population 44.1% and 43.8% were housewife in occupation. The majority of diabetic and non-diabetic participants suffered musculoskeletal pain in shoulder 18.80% and 13.60%, lower back 46.40% and 54.60%, and knee 44.90% and 24.10%. Only few participants, 29.9% diabetic and 27.2% non-diabetic patient has experienced paresthesia or numbness. It was found that 38.85% diabetic and 28.50% non-diabetic patients had muscle weakness and the majority of participants, 83.60% and 78.50% patients were facing difficulties during movement. Only a few diabetic and non-diabetic participants experienced swelling 2.9% and 2.5%, joint stiffness 4.4% diabetic and also 2.5% and muscle wasting 1.5% and 1.2%. Conclusion: Musculoskeletal conditions affect diabetes and non-diabetic people and cause pain, discomfort, and dysfunction. This effect also has an impact on the patient's quality of life. A multidisciplinary team strategy should be employed to treat the musculoskeletal issue of diabetic patients while also raising the standard of care for these patients

A comparative study to assess depression and anxiety in Type 2 diabetes mellitus patients in a tertiary care hospital

ABSTRACT Background: Diabetes is an alarming health problem affecting more than half a billion people globally. Diabetes is one of the most psychologically demanding illnesses and is frequently associated with anxiety and depression. The present study aimed to estimate the prevalence of depression and anxiety among diabetic patients and comparison of mental health assessment tools among diabetic and nondiabetic participants. Methodology: A comparative study of 80 diabetic patients attending the diabetology outpatient department and 80 age-matched nondiabetic attendees/relatives of patients attending the medicine outpatient department were randomly selected after fulfilling inclusion and exclusion criteria. After confirming their disease status, informed consent was obtained. Data were collected using a pretested questionnaire, mini international neuropsychiatric interview scale, beck depression inventory (BDI) for depression, and Hamilton Rating Scale for Anxiety scale (HAM-A) for anxiety. Results: Majority of the study participants in both groups (n = 35, 43.8%) were of 46–50 years old. About 52.5% of diabetic and 17.5% of nondiabetic participants were having depression and 51.3% of diabetic and 18.3% of nondiabetics were having anxiety as per BDI and HAM-A scores, respectively. Although major differences in sociodemographic variables such as socioeconomic class, gender, and place of residence, etc., between the two groups, it was not statistically significant. Conclusion: The present study shows depression and anxiety were more common among diabetic patients than nondiabetic participants. The risk for depression and anxiety is more among male patients, urban population, and those in low-socioeconomic status.

Higher Risk of Sarcopenia in Older Adults with Type 2 Diabetes: NHANES 1999–2018

Introduction: Recent studies suggested that sarcopenia may be a significant comorbidity of diabetes mellitus (DM). Nonetheless, studies with nationally representative data are scarce, and the changing trend of sarcopenia prevalence over time is largely unknown. Therefore, we aimed to estimate and compare the prevalence of sarcopenia in diabetic and nondiabetic US older population, and to explore the potential predictors of sarcopenia as well as the trend of sarcopenia prevalent in the past decades. Methods: Data were retrieved from the National Health and Nutrition Examination Survey (NHANES). Sarcopenia and DM were defined according to corresponding diagnosis criteria. Weighted prevalence was calculated and compared between diabetic and nondiabetic participants. The differences among age and ethnicity groups were explored. Results: A total of 6,381 US adults (>50 years) were involved. The overall prevalence of sarcopenia was 17.8% for US elders, and the prevalence was higher (27.9% vs. 15.7%) in those with diabetes ones than those without. Stepwise regression revealed that sarcopenia was significantly associated with DM (adjusted odds ratio = 1.37, 95% CI: 1.08–1.22; p < 0.05) after controlling for potential confounders including gender, age, ethnicity, educational level, BMI, and muscle strengthening activity. A slight fluctuation but overall increasing trend of sarcopenia prevalence was observed among diabetic elders, while no obvious changing trend was observed in their counterparts in recent decades. Conclusion: Diabetic US older adults face significantly higher risk of sarcopenia when compared with their nondiabetic counterparts. Gender, age, ethnicity, educational level, and obesity were important influencing factors of sarcopenia development.

Association between low-carbohydrate diet score and incidence of type 2 diabetes among Japanese adults: the JACC Study.

We prospectively examined the association between low-carbohydrate diet (LCD) score and incidence of type 2 diabetes (T2D) in Japanese adults using Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) data. A total of 19 084 (7052 men and 12 032 women) Japanese non-diabetic participants aged 40-79 years, who enrolled in the JACC study between 1988 and 1990, were included in our analysis. Dietary intake was evaluated using a validated food-frequency questionnaire. The overall, animal and vegetable LCD scores were calculated by dividing the study participants into eleven categories based on the percentages of energy from carbohydrates, protein and fat. The incidence of T2D was assessed using a self-administered questionnaire. We used multivariable logistic regression analysis to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs) of incident T2D across the quintile of each LCD score, with adjustment for potential confounders. During the 5-year study period, 490 adults (247 men and 243 women) developed T2D. The multivariable-adjusted OR of incident T2D for the highest v. lowest quintiles of overall and animal LCD scores, respectively, were 0·64 (95 % CI 0·42, 0·99) and 0·83 (95 % CI 0·55, 1·27) for men, 0·78 (95 % CI 0·51, 1·18) and 0·84 (95 % CI 0·57, 1·24) for women. The vegetable LCD score was associated with a lower risk of T2D in men (OR 0·51; 95 % CI 0·33, 0·77). Our results suggest that diets lower in carbohydrates and higher in fat and protein are unlikely to higher the T2D risk among Japanese individuals.

Multidrug-Resistant Escherichia coli Causing Urinary Tract Infections among Controlled and Uncontrolled Type 2 Diabetic Patients at Laquintinie Hospital in Douala, Cameroon.

Urinary tract infections (UTIs) in patients with diabetes are a major public health problem worldwide, particularly in developing countries. This study assessed the resistance profile of Escherichia coli and biochemical abnormalities in controlled and uncontrolled type 2 diabetic patients. A cross-sectional study was conducted at the Douala Laquintinie Hospital from January, 2020, to July, 2021, on the diabetic and nondiabetic participants. The clinical symptoms and biochemical parameters of patient having UTIs were measured using standard methods. E. coli was isolated from urine and an antibiotic susceptibility test was performed using the Kirby-Bauer Agar diffusion method. A total of 851 participants were included with a mean age of 48.54 years. Three hundred and forty-six (40.67%) were nondiabetic, 226 (26.56%) were diabetic patients with balanced blood sugar levels (i.e., glycosylated haemoglobin (HbA1c) is normal), and 279 (32.78%) were diabetic patients with unbalanced blood sugar levels (i.e., patients having an abnormal HbA1c). The prevalence of UTI caused by E. coli was significantly (p < 0.001) higher in diabetics with unbalanced blood sugar levels (15.41%) and diabetics with balanced blood sugar levels (9.73%) compared to nondiabetics (0.87%). Significant (p < 0.001) high frequencies of polyuria (48.39%), proteinuria (29.75%), leukocyturia (27.96%), and polyphagia (8.24%) were observed in diabetic participants with unbalanced blood sugar levels. Significantly (p < 0.001) high average values of aspartate transaminase (25.34; 27.07; 29.93), alanine transaminase (26.08; 27.38; 28.20), creatininemia (8.15; 9.67; 11.31), total cholesterol (1.57; 1.83; 2.63), and atherogenic index (3.81; 6.56; 11.73) were noted in nondiabetics, balanced, and unbalanced blood glucose diabetics, respectively. E. coli showed a high level of resistance to ciprofloxacin (30%), amoxicillin (10.8%), and ofloxacin (9.3%) in diabetic participants with unbalanced blood sugar levels. The antibiotic resistance patterns of the E. coli to triple, quadruple, and quintuple antibiotics were higher when participants had diabetes and even more when diabetes was not controlled. The present findings underline an increased susceptibility of diabetic patients with unbalanced blood sugar levels to multidrug resistant E. coli. Further studies should be conducted to determine the causal association between uncontrolled diabetes and bacterial multidrug resistance.

Comparative Evaluation of Plasma Lipid Profile and Electrolytes in Diabetic and Non-Diabetic Individuals Attending Healthcare Checkup in Everight Laboratory in Owerri, Imo State, Nigeria

Background: Diabetes mellitus is a metabolic disorder characterized by abnormally high blood sugar which poses a serious challenge to public health globally. The measurement of blood sugar levels, serum lipid profiles, and electrolytes are essential in determining one's vulnerability to developing diabetic-related complications such as cardiovascular diseases.&#x0D; Aim: This was a comparative cross-sectional study designed to assess the dyslipidemia and electrolyte imbalance status of diabetic individuals attending routine healthcare checkups in Everight Diagnostic and Laboratory Services Limited, Owerri branch, using plasma lipid profile (total cholesterol, triglycerides, high-density lipoproteins and low-density lipoproteins) and electrolytes (sodium, potassium, chloride and bicarbonate) as markers.&#x0D; Methodology: A total of 120 participants consisting of 60 diabetics and 60 non-diabetic individuals were pooled for this study. From both groups, plasma samples upon centrifugation were used for the analyses of glucose, Total Cholesterol (TC), Triglycerides (TG), High-density lipoprotein cholesterol (HDL-C), Low-density Lipoprotein Cholesterol using Erba XL-200 auto biochemistry analyzer, and plasma Sodium (Na+), Potassium (K+), Chloride (Cl-), and Bicarbonate (HCO3-) using Audicom (AC9900) ion selective electrode (ISE) analyzer. Statistical analysis was carried out using version 20.0 and p- values less than 0.05 were considered statistically significant.&#x0D; Results: The demographic characteristics of the study population show 53% women, 47% men, and average age of 51.28. The fasting plasma glucose level of diabetic subjects (175.96 ± 91.62 mg/dL) was significantly higher (p&lt;0.05) than the non-diabetic group (99.54 ± 11.50 mg/dL). More so, there were significant differences (p&lt;0.05) between levels of TC (212.9 ± 56.65 mg/dL), TG (165.61 ± 89.05 mg/dL), and LDL-C (130. 59 ± 47.18 mg/dL) amongst diabetic individuals when compared with the levels of TC (169.87 ± 33. 57 mg/dL), TG (98.14 ± 39.14 mg/dL), and LDL (100.57 ± 27.78 mg/dL) of non-diabetic participants. Conversely, there was no significant difference when the plasma levels of HDL-C (52.78 ± 19.10 mg/dL), Na+ (136.93 ± 3.14 mmol/L), K+ (4.11 ± 0.54 mmol/L), HCO3- (22.03 ± 4.66 mEq/L) and Cl- (101.09 ± 4.33 mmol/L) of test subjects were compared with that of control individuals HDL-C (53.46 ± 15.04 mg/dL), Na+ (137.11 ± 3.37 mmol/L), K+ (4.17 ± 0.45 mmol/L), HCO3- (22.27 ± 3.55 mEq/L) and Cl- (94.52 ± 10.78) (p&gt;0.05).&#x0D; Conclusion: The results of our study shows significant alteration of fasting lipid parameters amongst diabetics. This suggests that diabetic individuals are associated with dyslipidaemia, which predisposes them to cardiovascular risks.

Role of insulin resistance in relationship between cardiorespiratory fitness and cognitive speed/flexibility in older adults at risk for Alzheimer’s disease

AbstractBackgroundCardiorespiratory fitness (CRF) is thought to support cognition, though underlying mechanisms of this relationship are unclear. CRF is also negatively associated with insulin resistance, which is in turn damaging to cognition. We investigated the link between CRF and cognition and whether insulin resistance mediates this relationship.MethodWe included n = 1,157 cognitively unimpaired, nondiabetic participants. CRF was estimated using a validated equation that incorporates age, sex, BMI, resting heart rate, and physical activity as inputs. The Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR) quantified insulin resistance. Standardized composite scores for global cognition (PACC3), delayed recall, immediate learning, and executive function (including factor scores for working memory and cognitive speed/flexibility) were calculated from a battery of neuropsychological tests administered by trained psychometricians. Linear regression models tested whether CRF predicted each cognitive measure. Mediation analyses determined whether HOMA‐IR was responsible for significant associations between CRF and cognition. All analyses controlled for age, sex, years of education, familial history of Alzheimer’s disease, and Apolipoprotein E4 (APOE4) carriage. Bootstrapped confidence intervals were used to estimate the effect of HOMA‐IR on the CRF‐cognition relationship.ResultThe sample was comprised of 69.8% females and 38.7% APOE4 carriers with a mean age of 64.5 ± 7.2 years and a mean of 16.3 ± 2.8 years of education. CRF was positively associated with executive function (total effect: B = .015, SE = .005, p = .003) and cognitive speed/flexibility (total effect: B = .013, SE = .006, p = .034). CRF and executive function remained positively associated when including HOMA‐IR in the regression model (direct effect: B = .012, SE = .006, p = .040) and the estimated indirect effect of HOMA‐IR on the relationship was insignificant (B = .0031, CI = [‐.0020, .0087]). The association between CRF and cognitive speed/flexibility was attenuated when HOMA‐IR was added to the regression model (direct effect: B = .006, SE = .007, p = .383) and the estimated indirect effect of HOMA‐IR on the relationship was significant (B = .007, CI = [.0007, .0147]). CRF was not associated with PACC3 (p = .258), delayed recall (p = .970), immediate learning (p = .920), or working memory (p = .236).ConclusionAmong older adults at heightened risk for AD, insulin resistance mediates the relationship between CRF and cognitive speed/flexibility but not the relationship between CRF and executive function.

Factors affecting depression and anxiety in diabetic patients: A cross sectional study from a tertiary care hospital in Eastern India.

Diabetes is one of the most common chronic disease in the world and its prevalence in India is rising day by day. Diabetic patients often suffer from depression and anxiety which has a negative impact on patients resulting in non-adherence to medication, rapid disease progression and overall poor prognosis. India is the land of diversity and so are the causes of depression and anxiety in the people from different parts of the country. The study done in the current population has revealed certain indicators of both depression and anxiety that were not significant in previous studies. These new findings point towards the changing scenario and the need for more precise steps for improving the quality of life of diabetics. The study aims to determine the prevalence of depressive symptoms and anxiety among diabetic patients and the factors associated with them. A prospective cohort study was conducted with 305 participants among which 152 were diabetic while 153 were non diabetic patients. Depression and anxiety of the patients was measured through PHQ-9 scale and GAD-7 scale respectively. Factors associated with prevalence of depression and anxiety in the diabetic population was analysed. The prevalence of depressive symptoms (39.5% versus 12.4%) and anxiety (36.2% versus 14.4%) were significantly higher in diabetic patients as compared to non-diabetic participants. Low-income, urban residence, unmarried status, insulin therapy, presence of retinopathy, and ischemic heart disease were significantly associated with depression among diabetic group of patients. Similarly the major predictors of anxiety were marital status, literacy and diabetic complications like neuropathy, retinopathy and ischemic heart disease. Our study shows depression and anxiety are highly prevalent among diabetic patients. All diabetic patients while seeking clinical contact should be screened for depression and anxiety especially those patients with predisposing risk factors.

Reduced serum calcium is associated with a higher risk of retinopathy in non-diabetic individuals: The Chinese Multi-provincial Cohort Study.

As a common micro-vascular disease, retinopathy can also present in non-diabetic individuals and increase the risk of clinical cardiovascular disease. Understanding the relationship between serum calcium and retinopathy would contribute to etiological study and disease prevention. A total of 1836 participants (aged 55-84 years and diabetes-free) from the Chinese Multi-Provincial Cohort Study-Beijing Project in 2012 were included for analyzing the relation between serum calcium level and retinopathy prevalence. Of these, 1407 non-diabetic participants with data on serum calcium in both the 2007 and 2012 surveys were included for analyzing the association of five-year changes in serum calcium with retinopathy risk. The retinopathy was determined from retinal images by ophthalmologists and a computer-aided system using convolutional neural network (CNN). The association between serum calcium and retinopathy risk was assessed by multivariate logistic regression. Among the 1836 participants (male, 42.5%), 330 (18.0%) had retinopathy determined by CNN. After multivariate adjustment, the odds ratio (OR) comparing the lowest quartiles (serum calcium < 2.38 mmol/L) to the highest quartiles (serum calcium ≥ 2.50 mmol/L) for the prevalence of retinopathy determined by CNN was 1.58 (95% confidence interval [CI]: 1.10- 2.27). The findings were consistent with the result discerned by ophthalmologists, and either by CNN or ophthalmologists. These relationships are preserved even in those without metabolic risk factors, including hypertension, high hemoglobin A1c, high fasting blood glucose, or high low-density lipoprotein cholesterol. Over 5 years, participants with the sustainably low levels of serum calcium (OR: 1.58; 95%CI: 1.05 - 2.39) and those who experienced a decrease in serum calcium (OR: 1.56; 95%CI: 1.04 - 2.35) had an increased risk of retinopathy than those with the sustainably high level of serum calcium. Reduced serum calcium was independently associated with an increased risk of retinopathy in non-diabetic individuals. Moreover, reduction of serum calcium could further increase the risk of retinopathy even in the absence of hypertension, high glucose, or high cholesterol. This study suggested that maintaining a high level of serum calcium may be recommended for reducing the growing burden of retinopathy. Further large prospective studies will allow more detailed information.

Exercise as a non-pharmacological intervention to protect pancreatic beta cells in individuals with type 1 and type 2 diabetes.

Diabetes is characterised by progressive loss of functional pancreatic beta cells. None of the therapeutic agents used to treat diabetes arrest this process; preventing beta cell loss remains a major unmet need. We have previously shown that serum from eight young healthy male participants who exercised for 8 weeks protected human islets and insulin-producing EndoC-βH1 cells from apoptosis induced by proinflammatory cytokines or the endoplasmic reticulum (ER) stressor thapsigargin. Whether this protective effect is influenced by sex, age, training modality, ancestry or diabetes is unknown. We enrolled 82 individuals, male or female, non-diabetic or diabetic, from different origins, in different supervised training protocols for 8-12 weeks (including training at home during the COVID-19 pandemic). EndoC-βH1 cells were treated with 'exercised' serum or with the exerkine clusterin to ascertain cytoprotection from ER stress. The exercise interventions were effective and improved [Formula: see text] values in both younger and older, non-obese and obese, non-diabetic and diabetic participants. Serum obtained after training conferred significant beta cell protection (28% to 35% protection after 4 and 8 weeks of training, respectively) from severe ER stress-induced apoptosis. Cytoprotection was not affected by the type of exercise training or participant age, sex, BMI or ancestry, and persisted for up to 2 months after the end of the training programme. Serum from exercised participants with type 1 or type 2 diabetes was similarly protective. Clusterin reproduced the beneficial effects of exercised sera. These data uncover the unexpected potential to preserve beta cell health by exercise training, opening a new avenue to prevent or slow diabetes progression through humoral muscle-beta cell crosstalk.

Dietary Patterns and New-Onset Type 2 Diabetes Mellitus in Evacuees after the Great East Japan Earthquake: A 7-Year Longitudinal Analysis in the Fukushima Health Management Survey.

Background: Dietary patterns may be linked to the incidence of type 2 diabetes mellitus (T2DM) after disasters. We investigated the association between dietary patterns and new-onset T2DM in evacuees of the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Methods: Among the 22,740 non-diabetic participants aged 20-89 years who completed the dietary assessment in the Fukushima Health Management Survey between July 2011 and November 2012, the incidence of T2DM was evaluated until 2018. Principal component analysis with varimax rotation was applied to derive dietary patterns based on a validated, short-form food frequency questionnaire. The identified dietary patterns were categorized as typical Japanese, juice, and meat. Results: The cumulative incidence of T2DM was 18.0 and 9.8 per 1000 person-years in men and women, respectively, during the follow-up period. The multiple-adjusted hazard ratio (95% confidence interval) of the highest vs. lowest quartile of the typical Japanese pattern scores for T2DM was 0.80 (0.68, 0.94; P for trend = 0.015) in total, 0.85 (0.68, 1.06; P for trend = 0.181) in men, and 0.76 (0.60, 0.95; P for trend = 0.04) in women. Conclusions: A typical Japanese dietary pattern may be associated with a reduced new-onset T2DM risk in evacuees, especially women, after the Great East Japan Earthquake and the FDNPP accident.

Association between trajectories of fasting plasma glucose and risk of osteoporosis in non-diabetic and diabetic populations.

Previous studies based on a single measure of fasting plasma glucose (FPG) showed an inconsistent conclusion about the association between FPG and osteoporosis risk. Not accounting for time-varying and cumulative average of FPG over time could bias the true relation between FPG and osteoporosis. Our study aims to investigate the association between the trajectories of FPG and osteoporosis risk for non-diabetic and diabetic populations. A total of 18,313 participants who attended physical examinations during 2008-2018 were included. They were free of osteoporosis at their first physical examination and followed until their last physical examination before December 31, 2018. We recorded their incidence of osteoporosis and at least three FPG values during follow-up. Their longitudinal FPG trajectories were identified by the latent class growth analysis model based on the changes in FPG. Multivariable logistic regression models were used to analyze the association between the trajectories of FPG and osteoporosis diagnosed in the follow-up physical examination in both non-diabetics and diabetics. There were 752 incident osteoporosis among 16,966 non-diabetic participants, and 57 incident osteoporosis among 1,347 diabetic participants. Among non-diabetics, the elevated-increasing FPG trajectory was negatively associated with osteoporosis risk in women (odds ratio (OR), 0.62; 95% confidence interval (CI), 0.43-0.88). Premenopausal women with elevated-increasing FPG trajectory had lower osteoporosis risk than those women with normal-stable FPG trajectory (OR, 0.41; 95% CI, 0.20-0.88), while this association was insignificant in postmenopausal women. Among diabetics, those whose longitudinal FPG is kept at a very high level had the highest risk of osteoporosis (OR, 3.09; 95% CI, 1.16-8.22), whereas those whose FPG starts with the high level and keeps on increasing did not exhibit a significantly increased risk (OR, 1.75; 95% CI, 0.81-3.76) compared with those who keep stable moderate-high level of FPG, except in men (OR, 2.49; 95% CI, 1.02-6.12). Distinct trajectories of FPG are associated with differential risk of osteoporosis in non-diabetic and diabetic populations. Controlling a proper FPG level in different populations is necessary for osteoporosis prevention.

Effect of type 2 diabetes mellitus in adults undergoing fixed orthodontic treatment on proinflammatory chemokine profile and levels of advanced glycation in gingival crevicular fluid.

The current study aims to reconnoiter the outcome of diabetes mellitus type 2 (DMT2) on levels of advanced glycation end products (AGEs) and pro-inflammatory chemokine in gingival crevicular fluid (GCF) of individuals undergoing fixed orthodontic treatment. Participants were divided into a diabetic and no-diabetic group according to inclusion and exclusion criteria. Power analysis was adopted from a previous study that reported GCF chemokines in obese individuals. All teeth were measured for clinical periodontal parameters (CPP). GCF and saliva were collected 3 months after placing stainless steel archwire. GCF was investigated for pro-inflammatory cytokines all expressed in pg/mL. Quantification of chemokines was performed using a Magnetic bead-based multiplex assay for the Luminex® platform. Non-normality of data was assessed by Mann-Whitney U-test. Normality was estimated using an Independent t-test. Descriptive data were computed in the form of standard deviations and means. Unstimulated whole saliva flow rate (UWSFR) was significantly lower in diabetic patients compared to non-diabetics (p=.021). Amongst different clinical periodontal parameters (CPP) no difference in plaque scores (PS) and probing depth (PD) was found between diabetic and non-diabetic participants. Two GCF chemokines i.e., Resistin (p=.031) and AGEs (p=.017) were observed to be significantly higher in DMT2 participants compared to the non-diabetes group. CPP and GCF biomarkers in diabetic and non-diabetic individuals demonstrated a positive correlation between AGEs and GCF resistin levels concerning bleeding on probing (BoP) in diabetic patients. Participants with DMT2 after alignment with an orthodontic device exhibited significantly high levels of resistin and AGEs. The proinflammatory response was noted in patients with hyperglycemia undergoing orthodontic treatment.

Clinical Evaluation of Short Tuberosity Implants among Type 2 Diabetic and Non-Diabetic Patients: A 5 Year Follow-Up.

Aim: To assess clinical and radiographic parameters including bleeding on probing (BoP); probing depth (PD), plaque index (PI) and crestal bone loss (CBL) around short tuberosity implants (STI) supporting fixed partial dentures in patients with Type 2 diabetes mellitus (T2DM) and non-diabetics. Material and Methods: Participants with T2DM and without T2DM with at least one STI (6 mm) posteriorly restored with a fixed partial denture splinting premolar implant were included. A questionnaire collected demographic details including gender, age, duration of diabetes, habits of brushing, the total number of dental implants and location, implant loading after placement, restoration type, and family history of DM. Clinical and radiographic assessment of peri-implant parameters, i.e., bleeding on probing (BoP), probing depth (PD), plaque index (PI), and crestal bone loss (CBL) was performed. The restorative success of STI was determined by no sensation of the foreign body, lack of pain and dysesthesia, lack of infection, no radiolucency around the implant, and no mobility. The Kruskal–Wallis test was used for statistical analysis. A p-value of less than 0.05 was considered statistically significant. Results: Twenty-five T2DM (19 males and 6 females) and 25 non-diabetic (18 males and 7 females) participants were included. The number of STIs in T2DM was 41, whereas in non-diabetic it was 38. At 1 year follow-up, mean PI% in T2DM participants was 18.9% (19.2–21.4%) and in non-diabetics it was 17.6% (16.3–18.5%). The mean PD was recorded in diabetics (1.3 ± 5.0 mm) and non-diabetics (1.1 ± 3.2 mm). The BoP value in diabetics was 44.9% (39.8–46.4%) and 28.2% in non-diabetics (17.2–24.6%). At 5 years of follow-up, the mean PI% range in T2DM participants was 26.18% (25.4–29.1%) and 24.42% in non-diabetic (20.1–25.5%). The mean PD in millimeters around STI in T2DM was observed to be 2.3 ± 4.8 mm and 1.4 ± 3.4 mm in non-diabetics. In addition, BoP in diabetic participants was 39.54% (27.7–42.1%) and 24.42% in non-diabetics (20.1–25.5%). A total of six STIs failed, i.e., two in the non-diabetic and four in the T2DM group. Conclusions: Patients with T2DM have poor periodontal (BoP, PD, CBL) and restorative peri-implant parameters around STIs when compared to healthy (non-diabetic) participants at five years of follow-up. For long-term stability, glycemic control is pivotal along with following good plaque control.

Whole fresh fruit intake and risk of incident diabetes in different glycemic stages: a nationwide prospective cohort investigation

PurposeFruit intake is beneficial to several chronic diseases, but controversial in diabetes. We aimed to investigate prospectively the associations of whole fresh fruit intake with risk of incident type 2 diabetes (T2D) in subjects with different glucose regulation capacities.MethodsThe present study included 79,922 non-diabetic participants aged ≥ 40 years from an ongoing nationwide prospective cohort in China. Baseline fruit intake information was collected by a validated food frequency questionnaire. Plasma HbA1c, fasting and 2 h post-loading glucose levels were measured at both baseline and follow-up examinations. Cox proportional hazards models were used to calculate hazard ratio (HR) and 95% confidence intervals (CI) for incident diabetes among participants with normal glucose tolerance (NGT) and prediabetes, after adjusted for multiple confounders. Restricted cubic spline analysis was applied for dose–response relation.ResultsDuring a median 3.8-year follow-up, 5886 (7.36%) participants developed diabetes. Overall, we identified a linear and dose-dependent inverse association between dietary whole fresh fruit intake and risk of incident T2D. Each 100 g/d higher fruit intake was associated with 2.8% lower risk of diabetes (HR 0.972, 95%CI [0.949–0.996], P = 0.0217), majorly benefiting NGT subjects with 15.2% lower risk (HR 0.848, 95%CI [0.766–0.940], P = 0.0017), while not significant in prediabetes (HR 0.981, 95%CI 0.957–4.005, P = 0.1268). Similarly, the inverse association was present in normoglycemia individuals with a 48.6% lower risk of diabetes when consuming fruits > 7 times/week comparing to those < 1 time/week (HR 0.514, 95% CI [0.368–0.948]), but not in prediabetes (HR 0.883, 95% CI [0.762–1.023]).ConclusionThese findings suggest that higher frequency and amount of fresh fruit intake may protect against incident T2D, especially in NGT, but not in prediabetes, highlighting the dietary recommendation of higher fresh fruit consumption to prevent T2D in normoglycemia population.

Modifiable predictors of type 2 diabetes mellitus and roles of insulin resistance and β-cell function over a 6-year study and 30-year follow-up.

This study aimed to examine the modifiable predictors of T2DM and the roles of insulin resistance (IR) and β-cell function over a 6-year study and 30-year follow-up. A total of 462 non-diabetic participants, 282 with impaired glucose tolerance (IGT), and 180 with normal glucose tolerance (NGT) were enrolled in this analysis. The Matsuda IR index and area under the curve of insulin-to-glucose ratio (AUCI/G-R) were used as IR and β-cell function indices in the analysis. In all participants, multivariable analysis showed that BMI, glucose status, Matsuda IR index and systolic blood pressure (SBP) at baseline were independently associated with an increased risk of T2DM over 30years, whereas lifestyle intervention and AUCI/G-R were inversely associated with this risk. The predictive effect of the Matsuda IR index and AUCI/G-R in participants with IGT was consistent with the results of all participants, whereas in those with NGT, only the Matsuda IR index, not the AUCI/G-R, predicted the development of T2DM (HR = 1.42, 95% CI 1.07-1.89 vs HR = 1.09, 95% CI 0.76-1.56). The predictive effect of the Matsuda IR index on T2DM existed even in participants with BMI < 25 (p = 0.049). The modifiable predictors of T2DM in Chinese adults were high BMI, hypertension, mild hyperglycaemia, IR, and β-cell dysfunction. Both IR and β-cell function contributed to the development of T2DM in the long term; however, IR remains the initial and long-standing key risk factor for T2DM.

Diabetes Mellitus is Associated With Higher Serum Neurofilament Light Chain Levels in the General US Population.

Serum neurofilament light chain (sNfL) levels are biomarkers of neuroaxonal injury in multiple neurological diseases. Given the paucity of data on the distribution of sNfL levels in the general population, in the present study we identified predictors of sNfL levels in a community setting and investigated the association between diabetes and sNfL. sNfL levels were measured in 2070 people aged 20 to 75 years from the general US population (275 with and 1795 without diabetes) that participated in the 2013-2014 cycle of the National Health and Nutrition Examination Survey. We evaluated the association between diabetes and sNfL levels after adjustment for age, sex, race-ethnicity, alcohol use, and kidney function using a multivariable linear regression model. Cognitive function was evaluated in a subset of participants aged 60 to 75 years using the Consortium to Establish a Registry for Alzheimer's Disease-Word Learning test, the Animal Fluency test, and the Digit Symbol Substitution test. The weighted prevalence of diabetes was 10.4% (95% CI, 9.0-11.9). In each age stratum, patients with diabetes exhibited higher sNfL levels compared with nondiabetic participants. Age, proportion of males, prevalence of diabetes, and homeostatic model of insulin resistance increased progressively across quartiles of sNfL levels in the overall population, whereas estimated glomerular filtration rate (eGFR) showed an opposite trend. In the multivariable model, age, sex, eGFR, alcohol use and diabetes were significantly associated with sNfL levels. Moreover, higher sNfL levels were associated with worse performance in all 3 cognitive function tests. Diabetes is associated with higher sNfL. Further large-scale and prospective studies are needed to replicate our results and evaluate the ability of sNfL to predict the incidence of neuropathy and dementia in this patient population.

S112 Implications of Butyrate Kinase and Intestinal Microbiota on Diabetes Risk in a Community Enriched With Native Hawaiians

Introduction: The incidence of type 2 diabetes mellitus (T2DM) within the Native Hawaiian population among the highest of any major ethnic group within the state of Hawaii. Modern research is beginning to mechanistically understand ancient Hawaiian concepts and practices demonstrating the importance of environment to human health. Environmental factors, such as socioeconomic status, toxicants, diet/nutrition, etc, contribute to individual risk of T2DM, where impacts on the gut microbiome may play key roles in inflammatory and metabolic dysregulation characteristic of diabetes. In this study, we focused on understanding the relationship between the gut microbiome and T2DM risk in the Native Hawaiian population. Methods: The study enrolled a cohort of Hawaii residents (16 years or older) in a community enriched with Native Hawaiians. Microbial DNA was isolated from self-collected stool samples of all participants and used for 16S amplicon-based sequencing for metagenomic analyses and for quantifying microbial-specific butyrate kinase (BUK) gene expression levels using qPCR approaches. From each participant, anthropometric measures and blood levels of HbA1c, a diagnostic indicator of T2DM, were taken. Blood was collected by venous puncture from which plasma was isolated to measure inflammatory and metabolic biomarkers. Herein, we identified and describe significant differences between diabetic and non-diabetic microbiome composition and diversity. Results: Consistent with other studies, we observed increased levels of CRP (p< 0.01) and decreased levels of leptin (p=0.04) in the plasma of diabetic compared to non-diabetic participants. Additionally, we observed that BUK levels were negatively correlated with that of HbA1c (R=-0.18, p=0.04), and positively correlated with that of metabolic hormones PYY (R=0.30; p=0.007) and GLP-1 (R=0.19; p=0.04), which were largely attributed to diabetes status. Higher plasma levels of PYY and GLP-1 have previously been associated with reduced T2DM risk. Conclusion: Altogether, our data suggest a role for butyrate-producing gut bacteria in the maintenance of the homeostatic inflammatory and metabolic states that are dysregulated in the progression of T2DM and implicates novel targets for reducing T2DM risk among health disparate populations.