Occurrence Of Type 2 Diabetes Mellitus Research Articles

The Expression of MAFB Gene in Circulating Monocytes Is Related to Chronic Inflammatory Status in T2DM Patients.

Immune cell-mediated chronic inflammation is one of the causes of type 2 diabetes mellitus (T2DM). Therefore, identifying inflammatory markers in circulating immune cells is highly important for predicting insulin resistance (IR) and the occurrence of T2DM. In this study, we discovered that differentially expressed genes (DEGs) in peripheral blood mononuclear cells (PBMCs) from T2DM patients were associated with innate immunity and chronic inflammatory responses through bulk transcriptome sequencing (bulk RNA-seq). Gene integration analysis revealed that nine DEGs were upregulated, and receiver operating characteristic (ROC) curve analysis revealed that V-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB), a candidate biomarker, has a certain predictive value for T2DM. In population-based cohort studies, we found that MAFB expression was significantly upregulated in the PBMCs of T2DM patients and was significantly correlated with homeostasis model assessment of IR (HOMA-IR), tumor necrosis factor-α (TNF-α), adiponectin (Adipoq), etc. We further evaluated the sensitivity and specificity of MAFB and other clinical parameters for predicting and diagnosing T2DM and found that MAFB expression in PBMCs had a positive effect on the prediction and diagnosis of T2DM. Finally, single-cell RNA sequencing (scRNA-seq) analysis revealed that the increase in MAFB expression was mainly in nonclassical monocytes. Our results suggest that increased MAFB expression in circulating monocytes may mediate chronic inflammatory status in patients with T2DM. Therefore, MAFB gene expression in circulating monocytes has certain clinical significance for predicting and assisting in the diagnosis of T2DM.

17β-Estradiol, through activating the G protein-coupled estrogen receptor, exacerbates the complication of benign prostate hyperplasia in type 2 diabetes mellitus patients by inducing prostate proliferation

Benign prostate hyperplasia (BPH) is one of the major chronic complications of type 2 diabetes mellitus (T2DM), and sex steroid hormones are common risk factors for the occurrence of T2DM and BPH. The profiles of sex steroid hormones are simultaneously quantified by LC-MS/MS in the clinical serum of patients, including simple BPH patients, newly diagnosed T2DM patients, T2DM complicated with BPH patients and matched healthy individuals. The G protein-coupled estrogen receptor (GPER) inhibitor G15, GPER knockdown lentivirus, the YAP1 inhibitor verteporfin, YAP1 knockdown/overexpression lentivirus, targeted metabolomics analysis, and Co-IP assays are used to investigate the molecular mechanisms of the disrupted sex steroid hormones homeostasis in the pathological process of T2DM complicated with BPH. The homeostasis of sex steroid hormone is disrupted in the serum of patients, accompanying with the proliferated prostatic epithelial cells (PECs). The sex steroid hormone metabolic profiles of T2DM patients complicated with BPH have the greatest degrees of separation from those of healthy individuals. Elevated 17β-estradiol (E2) is the key contributor to the disrupted sex steroid hormone homeostasis, and is significantly positively related to the clinical characteristics of T2DM patients complicated with BPH. Activating GPER by E2 via Hippo-YAP1 signaling exacerbates high glucose (HG)-induced PECs proliferation through the formation of the YAP1-TEAD4 heterodimer. Knockdown or inhibition of GPER-mediated Hippo-YAP1 signaling suppresses PECs proliferation in HG and E2 co-treated BPH-1 cells. The anti-proliferative effects of verteporfin, an inhibitor of YAP1, are blocked by YAP1 overexpression in HG and E2 co-treated BPH-1 cells. Inactivating E2/GPER/Hippo/YAP1 signaling may be effective at delaying the progression of T2DM complicated with BPH by inhibiting PECs proliferation.

Comparative study of type 2 diabetes mellitus-associated gut microbiota between the Dai and Han populations.

The global prevalence of type 2 diabetes mellitus (T2DM) is increasing. T2DM is associated with alterations of the gut microbiota, which can be affected by age, illness, and genetics. Previous studies revealed that there are discriminating microbiota compositions between the Dai and the Han populations. However, the specific gut microbiota differences between the two populations have not been elucidated. To compare the gut microbiota differences in subjects with and without T2DM in the Dai and Han populations. A total of 35 subjects of the Han population (including 15 healthy children, 8 adult healthy controls, and 12 adult T2DM patients) and 32 subjects of the Dai population (including 10 healthy children, 10 adult healthy controls, and 12 adult T2DM patients) were enrolled in this study. Fasting venous blood samples were collected from all the subjects for biochemical analysis. Fecal samples were collected from all the subjects for DNA extraction and 16S rRNA sequencing, which was followed by analyses of the gut microbiota composition. No significant difference in alpha diversity was observed between healthy children and adults. The diversity of gut microbiota was decreased in T2DM patients compared to the healthy adults in both the Dai and Han populations. There was a significant difference in gut microbiota between healthy children and healthy adults in the Han population with an increased abundance of Bacteroidetes and decreased Firmicutes in children. However, this difference was less in the Dai population. Significant increases in Bacteroidetes in the Han population and Proteobacteria in the Dai population and decreases in Firmicutes in both the Han and Dai population were observed in T2DM patients compared to healthy adults. Linear discriminant analysis Effect Size analysis also showed that the gut microbiota was different between the Han and Dai populations in heathy children, adults, and T2DM patients. Four bacteria were consistently increased and two consistently decreased in the Han population compared to the Dai population. Differences in gut microbiota were found between the Han and Dai populations. A significant increase in Bacteroidetes was related to the occurrence of T2DM in the Han population, while a significant increase in Proteobacteria was related to the occurrence of T2DM in the Dai population.

CDKN2B-AS (rs2891168), SOD2 (rs4880), and PON1 (rs662) polymorphisms and susceptibility to coronary artery disease and type 2 diabetes mellitus in Iranian patients: A case-control study.

Coronary artery disease (CAD) is a devastating illness and primary cause of death worldwide that arises from a combination of genetic and environmental factors. Several large-scale studies found that 9p21.3, superoxide dismutase 2 (SOD2), and paraoxonase 1 (PON1) polymorphisms increase type 2 diabetes mellitus (T2DM) and/or coronary artery disease (CAD) risk. Our research aimed to investigate whether the SNPs of the 9p21.3 locus (rs28911698), SOD2 (rs4880), and PON1 (rs662) genes were associated with the risk of T2DM and/or CAD in the Iranian population. In this case-control study four group subjects including patients with CAD non-T2DM, with CAD and T2DM, non-CAD with T2DM, and non-CAD non-T2DM were recruited to the study from 2019 to 2020. Molecular analysis was carried out by allele specific-polymerase chain reaction (AS-PCR) technique for rs4880, Taqman genotyping assay for rs2891168, and PCR followed by restriction fragment length polymorphism (PCR-RFLP) technique for rs662. The rs2891168 polymorphism presented an elevated risk of CAD in non-T2DM with CAD and with T2DM CAD groups compared to the non-T2DM non-CAD group with GG genotype and dominant model after adjustment (p < 0.05). G-allele in PON1 rs662 polymorphism associated with increased risk of T2DM in T2DM non-CAD, and T2DM CAD groups compared to non-T2DM non-CAD group with dominant model, GG and AG genotypes (p < 0.05). However, SOD2 rs4880 polymorphism presented no significant association with the development of diabetes or CAD. These results provide a prime witness that rs2891168 and rs662 gene variants might have a possible increased risk of CAD and T2DM occurrence, respectively. To obtain more definitive and accurate results in this area, further research is required.

Depression in Type 2 Diabetes Mellitus and its Relation with Complications of Diabetes Mellitus: A Cross-sectional Study in Central India

Background: The prevalence of Type 2 diabetes mellitus (T2DM) and depression has witnessed a steep rise. The relationship between these two conditions has been mostly studied in Western countries. The existing literature indicates that depression is more common in T2DM. However, data regarding its association with clinical profile of diabetes is conflicting. Despite the extensive occurrence of T2DM and depression in India, research on their association is limited. Aims and Objectives: To study the prevalence of depression and its association with complications of T2DM among inpatients of T2DM in a tertiary care center in Central India. Materials and Methods: Inpatients department of Medicine was taken as study site and 120 inpatients of T2DM aged 18 to 65 years were recruited after applying strict inclusion and exclusion criteria. They were assessed for depression using structured interview and ICD-10 criteria. The severity was assessed by HAMD-17 (Hamilton Rating Scale for Depression). The complications of diabetes were assessed. Results: The prevalence of depression in T2DM patients was 24.2% (29 cases) among which mild depression was present in 62.1% cases. There was a significant positive association (p&lt;0.05) between depression and socio-demographic variables of age, female gender, rural habitat and lower socio-economic status. There was a significant positive association between depression and duration of diabetes, BMI, serum triglyceride, serum creatinine and a significant negative association with serum HDL. Depression had a significant positive association with nephropathy and Coronary Artery Disease (CAD). Conclusion: The prevalence of depression is higher in T2DM as compared to normal population and is significantly associated with nephropathy and coronary artery disease. The findings highlight the need for timely screening of depression and integrated management approach.

Population attributable fractions of fatty liver disease for type 2 diabetes Mellitus

PurposeTo determine the population attributable fraction (PAF) of fatty liver disease (FLD) for type 2 diabetes mellitus (T2DM) and compare it to the PAFs of other metabolic abnormalities.MethodsWe conducted a 10-year retrospective cohort study of 33,346 individuals in Karamay Central Hospital of Xinjiang. Individuals were followed up for T2DM occurrence based on FBS. The PAFs of FLD were calculated generally and respectively in different sex and age groups. A comparison of the PAF of FLD and that of other metabolic abnormalities, as well as the PAFs of FLD in different groups classified based on age and sex, was performed using Cox regression.ResultsDuring an average follow-up period of 3.71 years, 1486 T2DM were diagnosed. The incidence density of T2DM was 1.2/100 person-years, and cumulative incidence rate was 4456.31/100,000 person-years. Partial PAF (PAFp) of FLD in the entire population was 23.11%. In the male population, PAFp was higher at 30–40 years old. In the female population, it was higher when age ≥ 60 years old. In multivariable Cox regression model, FLD, male sex, age ≥ 45 years old, overweight, hypertriglyceridaemia, and systolic hypertension were independent risk factors for T2DM, with corresponding PAFp of 25.00%, 24.99%, 36.47%, 24.96%, 5.71%, and 6.76%, respectively. Age ≥ 45 years old showed the highest PAFp and adjusted hazard ratio, followed by FLD.ConclusionsFLD contributes more to T2DM incidence than other metabolic disorders. Particular attention should be given to male populations of 30–40 and female populations above 60 for FLD prevention and treatment.

The circadian rhythm: an influential soundtrack in the diabetes story.

Type 2 Diabetes Mellitus (T2DM) has been the main category of metabolic diseases in recent years due to changes in lifestyle and environmental conditions such as diet and physical activity. On the other hand, the circadian rhythm is one of the most significant biological pathways in humans and other mammals, which is affected by light, sleep, and human activity. However, this cycle is controlled via complicated cellular pathways with feedback loops. It is widely known that changes in the circadian rhythm can alter some metabolic pathways of body cells and could affect the treatment process, particularly for metabolic diseases like T2DM. The aim of this study is to explore the importance of the circadian rhythm in the occurrence of T2DM via reviewing the metabolic pathways involved, their relationship with the circadian rhythm from two perspectives, lifestyle and molecular pathways, and their effect on T2DM pathophysiology. These impacts have been demonstrated in a variety of studies and led to the development of approaches such as time-restricted feeding, chronotherapy (time-specific therapies), and circadian molecule stabilizers.

Epidemiological and transcriptome data identify potential key genes involved in iron overload for type 2 diabetes

BackgroundMany previous studies have reported the association between iron overload (IO) and type 2 diabetes mellitus (T2DM). However, the underlying molecular mechanism is not clear.MethodsEpidemiological data from the National Health and Nutrition Examination Survey 2017–2018 (NHANES) was used to systematically explore the association between IO and diabetes. Furthermore, transcriptome data from Gene Expression Omnibus (GEO) were analyzed using bioinformatics methods to explore the underlying functional mechanisms at the molecular level.ResultsData from NHANES showed a “W” shape relationship between serum iron (frozen) and the risk of diabetes (P < 0.001) as well as a “∧” shape correlation between serum unsaturated iron binding capacity (UIBC) and the risk of diabetes (P = 0.007). Furthermore, the serum iron (frozen) was positively associated with fasting plasma glucose and HOMAB (P < 0.05), and UIBC was positively associated with fasting insulin (P < 0.05). Transcriptome data showed that two IO-related genes [Transferrin receptor (TFRC) and Solute carrier family-11 member-2 (SLC11A2)] were down-regulated in T2DM. The correlation analysis showed that expression levels of TFRC and SLC11A2 were significantly and positively correlated with genes involved in insulin secretion (P < 0.05). Protein–protein interaction network analysis showed that TFRC and SLC11A2 interacted with four key genes, including VAMP2, HIF1A, SLC2A1, and RAB11FIP2.ConclusionWe found that IO status was associated with increased FPG and aggravated HOMAB, and two IO-related genes (TFRC and SLC11A2) might induce the occurrence of T2DM by influencing insulin secretion, which provides potential therapeutic targets for T2DM patients.

Ethanol extract of propolis regulates type 2 diabetes in mice via metabolism and gut microbiota.

Propolis is a traditional natural medicine with various activities such as antioxidant and anti-inflammatory, immunomodulatory, anti-tumour, gastroenteritis treatment and prevention, anti-microbial and parasitic, as well as glucose regulation and anti-diabetes, and is expected to be an anti-diabetic candidate with few side effects, but the mechanism of action of propolis on type 2 diabetes mellitus (T2DM) has not been fully elucidated. The purpose of this study was to investigate the mechanism of the effect of ethanol extract of propolis (EEP) on the regulation of blood glucose in T2DM mice. We studied the possible mechanism of EEP on T2DM using an animal model of T2DM induced by a combination of a high-fat diet and intraperitoneal injection of streptozotocin (STZ). The experiment was divided into four groups, namely, the normal group (HC), model group (T2DM), EEP and metformin group (MET). Biochemical indexes and cytokines were measured, and the differences of metabolites in the serum were compared by 1H-NMR. In addition, the diversity of intestinal flora in feces was studied by 16S rDNA amplicon sequencing. The results showed that following treatment with EEP and MET, the weight-loss trend of mice was alleviated, and the fasting blood glucose, insulin secretion level, insulin resistance index, C peptide level and oral glucose tolerance level decreased, whereas the insulin sensitivity index increased, thereby EEP effectively alleviated the occurrence of T2DM and insulin resistance. Compared with the T2DM group, the concentrations of pro-inflammatory cytokines interleukin-1 beta (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) decreased significantly in EEP and MET groups, whereas the concentrations of anti-inflammatory cytokine interleukin-10 (IL-10) increased significantly. Metabolomics results revealed that EEP and MET regulate carbohydrate metabolism and restore amino acid and lipid metabolism. Correlation analysis of intestinal flora in mouse feces showed that compared with the HC group, harmful bacteria such as Bilophila, Eubacterium_ventriosum_group, Mucispirillum and Desulfovibrio were found in the T2DM group, whereas the abundance of beneficial bacteria such as Lactobacillus was significantly reduced. Parabacteroides, Akkermansia, Leuconostoc, and Alloprevotella were abundantly present in the EEP group; however, the MET group showed an increase in the genus Parasutterella, which could regulate energy metabolism and insulin sensitivity. The results showed that EEP and MET reduce fasting blood glucose in T2DM mice, followed by alleviating insulin resistance, improving the inflammatory reaction of mice, regulating the metabolism of mice, and affecting the steady state of gut microbiota. However, the overall therapeutic effect of EEP is better than that of MET.

Cardiac Structural and Functional Features in Patients With Type 2 Diabetes Mellitus and Heart Failure With Preserved Ejection Fraction:A Study Based on Propensity Score Matching

Objective To investigate the cardiac structural and functional characteristics in the patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM),and predict the factors influencing the characteristics. Methods A total of 783 HFpEF patients diagnosed in the Department of Geriatric Cardiology,the First Hospital of Lanzhou University from April 2009 to December 2020 were enrolled in this study.Echocardiography and tissue Doppler technique were employed to evaluate cardiac structure and function.According to the occurrence of T2DM,the patients were assigned into a HFpEF+T2DM group (n=332) and a HFpEF group (n=451).Propensity score matching (PSM)(in a 1∶1 ratio) was adopted to minimize confounding effect.According to urinary albumin excretion rate (UAER),the HFpEF+T2DM group was further divided into three subgroups with UAER<20 μg/min,of 20-200 μg/min,and>200 μg/min,respectively.The comorbidities,symptoms and signs,and cardiac structure and function were compared among the groups to clarify the features of diabetes related HFpEF.Multivariate linear regression was conducted to probe the relationship of systolic blood pressure,blood glucose,glycosylated hemoglobin,and UARE with cardiac structural and functional impairment. Results The HFpEF+T2DM group had higher prevalence of hypertension (P=0.001) and coronary heart disease (P=0.036),younger age (P=0.020),and larger body mass index (P=0.005) than the HFpEF group,with the median diabetic course of 10 (3,17) years.After PSM,the prevalence of hypertension and coronary heart disease,body mass index,and age had no significant differences between the two groups(all P>0.05).In addition,the HFpEF+T2DM group had higher interventricular septal thickness (P=0.015),left ventricular posterior wall thickness (P=0.040),and left ventricular mass (P=0.012) and lower early diastole velocity of mitral annular septum (P=0.030) and lateral wall (P=0.011) than the HFpEF group.Compared with the HFpEF group,the HFpEF+T2DM group showed increased ratio of early diastolic mitral filling velocity to early diastolic mitral annular velocity (E/e') (P=0.036).Glycosylated hemoglobin was correlated with left ventricular mass (P=0.011),and the natural logarithm of UAER with interventricular septal thickness (P=0.004),left ventricular posterior wall thickness (P=0.006),left ventricular mass (P<0.001),and E/e' ratio (P=0.049). Conclusion The patients with both T2DM and HFpEF have thicker left ventricular wall,larger left ventricular mass,more advanced left ventricular remodeling,severer impaired left ventricular diastolic function,and higher left ventricular filling pressure than the HFpEF patients without T2DM.Elevated blood glucose and diabetic microvascular diseases might play a role in the development of the detrimental structural and functional changes of the heart.

Puerperium experience and lifestyle in women with gestational diabetes mellitus and overweight/obesity in China: A qualitative study.

Women with overweight or obesity and gestational diabetes mellitus (GDM) are at a high risk of developing type 2 diabetes mellitus (T2DM) and other metabolic diseases. Healthy postpartum lifestyles in women with GDM are important for effectively preventing early T2DM occurrence; however, few studies and guidelines focus in China on this issue. This qualitative study aimed to understand the puerperium experience and lifestyle of women with overweight/obesity and GDM. A face-to-face, in-depth, and semi-structured interview was conducted using a hermeneutical phenomenology method to collect data that were analyzed through thematic analysis. Out of 61 recruited women with overweight/obesity and history of GDM, 14 women underwent an interview and provided detailed descriptions of their lifestyle experiences during puerperium. The interview data were used to generate four themes-puerperium dietary behavior, weight perception and "confinement" behavior, family support, disease knowledge, and perceived risk-and nine sub-themes. Unhealthy lifestyles, misconceptions about food, the conflict between physical activity and confinement behavior, a lack of social and family support, and low awareness of disease risk are all common among overweight/obese women with a history of GDM. Thus, we emphasized that healthcare providers should provide continuous preventive care from pregnancy to postpartum and promote long-term health in high-risk populations with a history of GDM associated with overweight/obesity.

U-shaped association between serum IGF2BP3 and T2DM: A cross-sectional study in Chinese population.

To clarify the expression of N6-methyladenosine (m6 A) modulators involved in the pathogenesis of type 2 diabetes mellitus (T2DM). We further explored the association of serum insulin-like growth factor 2 mRNA-binding proteins 3 (IGF2BP3) levels and odds of T2DM in a high-risk population. The gene expression data set GSE25724 was obtained from the Gene Expression Omnibus, and a cluster heatmap was generated by using the R package ComplexHeatmap. Differential expression analysis for 13 m6 A RNA methylation regulators between nondiabetic controls and T2DM subjects was performed using an unpaired t test. A cross-sectional design, including 393 subjects (131 patients with newly diagnosed T2DM, 131 age- and sex-matched subjects with prediabetes, and 131 healthy controls), was carried out. The associations between serum IGF2BP3 concentrations and T2DM were modeled by restricted cubic spline and logistic regression models. Two upregulated (IGF2BP2 and IGF2BP3) and 5 downregulated (methyltransferase-like 3 [METTL3], alkylation repair homolog protein 1 [ALKBH1], YTH domain family 2 [YTHDF2], YTHDF3, and heterogeneous nuclear ribonucleoprotein [HNRNPC]) m6 A-related genes were found in islet samples of T2DM patients. A U-shaped association existed between serum IGF2BP3 levels and odds of T2DM according to cubic natural spline analysis models, after adjustment for body mass index, waist circumference, diastolic blood pressure, total cholesterol, and triglyeride. Multivariate logistic regression showed that progressively higher odds of T2DM were observed when serum IGF2BP3 levels were below 0.62 ng/mL (odds ratio 3.03 [95% confidence interval 1.23-7.47]) in model 4. Seven significantly altered m6 A RNA methylation genes were identified in T2DM. There was a U-shaped association between serum IGF2BP3 levels and odds of T2DM in the general Chinese adult population. This study provides important evidence for further examination of the role of m6 A RNA methylation, especially serum IGF2BP3 in T2DM risk assessment.

Allelic Discrimination of Vitamin D Receptor Polymorphisms and Risk of Type 2 Diabetes Mellitus: A Case-Controlled Study.

(1) Background: Type 2 diabetes mellitus (T2DM) is one of the rapidly growing healthcare problems, and several vitamin D receptor (VDR) polymorphisms seem to modulate the risk of T2DM. Our research was designed to investigate the allelic discrimination of VDR polymorphisms and T2DM occurrence risk. (2) Methods: This case-control research included 156 patients with T2DM and 145 healthy control subjects. Most of the study population were males 56.6% vs. 62.8% in the case and control groups, respectively. Genotyping for VDR single nucleotide polymorphisms (SNPs), rs228570 (Fok1), rs7975232 (Apa1), and rs1544410 (Bsm1) was compared between both groups. (3) Results: There was a negative link between vitamin D levels and insulin sensitivity. A significant difference was noted in the allelic discrimination of VDR polymorphism rs228570 and rs1544410 between the study groups (p < 0.001). No difference was observed in the allelic discrimination of VDR polymorphism rs7975232 between the groups (p = 0.063). Moreover, T2DM patients had significantly higher levels of fasting blood sugar (FBS), glycated hemoglobin HbA1c, 2-h post-prandial blood sugar (PP), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), total cholesterol, and triglycerides (p < 0.001), while High-Density Lipoprotein (HDL) Cholesterol (HDL-C) was significantly decreased (p = 0.006). (4) Conclusions: VDR polymorphisms had a positive association with T2DM risk among the Egyptian population. Further large-scale research using deep sequencing of samples is strongly urged to investigate different vitamin D gene variants and interactions, as well as the influence of vitamin D on T2DM.

The relationship between the ratio of gamma-glutamyltransferase to high-density lipoprotein cholesterol and the risk of diabetes mellitus using publicly available data: a secondary analysis based on a longitudinal study in Japan

BackgroundThe ratio of gamma-glutamyltransferase to high-density lipoprotein cholesterol (GGT/HDL-C) has been highlighted in nonalcoholic fatty liver disease (NAFLD) by previous studies. However, there have been fewer investigations into the correlation between the GGT/HDL-C ratio and type 2 diabetes mellitus (T2DM) incidence. Our secondary analysis used published data from a Japanese population and aimed to investigate the role of the GGT/HDL-C ratio in the incidence of T2DM.MethodsThe research was a longitudinal cohort study completed by Okamura, Takuro et al. We obtained the data from the DATADRYAD website and used it for secondary analysis only. The participants recruited from a medical program called the NAGALA database received regular medical examinations and standardized questionnaires to obtain the baseline variables. Abdominal ultrasound was used to diagnose fatty liver disease. The participants were followed up, and the duration and occurrence of T2DM were documented. The GGT/HDL-C ratio evaluated at baseline served as the independent variable, while the occurrence of diabetes served as the dependent variable.ResultsA total of 15,453 cases (8,419 men and 7,034 women) were included in our study. After adjusting for age, sex, BMI, DBP, SBP, ALT, AST, TG, TC, HbA1C, FPG, drinking status, smoking status, exercise status, and fatty liver, we observed that the GGT/HDL-C ratio was positively associated with the incidence of T2DM (hazard ratio = 1.005, 95% confidence interval: 1.000 to 1.010, P = 0.0667). The results were consistent when the GGT/HDL-C quartile was used as a categorical variable (P for trend < 0.00396). A curvilinear relationship with a threshold effect was identified between the GGT/HDL-C ratio and the risk of incident T2DM. On the left of the point, a one-unit increase in the GGT/HDL-C ratio was associated with a 1.5-fold increase in the risk of incident T2DM (hazard ratio 2.57, 95% confidence interval 1.20 to 5.49). On the right of the point, when GGT/HDL-C was greater than 6.53, their relationship became saturated.ConclusionThe GGT/HDL-C ratio correlated with the incidence of T2DM in a curvilinear form with a threshold effect. Their positive relationship could be observed when GGT/HDL-C was less than 6.53.

Volumetrijska analiza lipidnih kapi u limfocitima bolesnika sa tip 2 dijabetes melitusom i hiperlipidemijom

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by inadequate glucose homeostasis. A common occurrence of T2DM is diabetic dyslipidemia. Given lipid droplets' role in intracellular lipid storage, these structures lie at the center of lipid and energy homeostasis. Lipolysosomes are cell organelles that have the structure of lipid droplets surrounded by a membrane. Lipophagy is a selective form of autophagy that enables lipid droplet degradation, thus representing an important mechanism in the regulation of lipid droplet homeostasis. Aim: The aim of our research was fractional volume analysis of lipid droplets, autophagic vesicles containing lipid droplets, and lipolysosomes in the lymphocytes of patients with T2DM and hyperlipidemia. Material and methods: Mononuclear cells were isolated from the peripheral blood of T2DM patients with hyperlipidemia and from healthy individuals. Cells were fixed in glutaraldehyde and postfixed in 1% osmium tetroxide. After contrasting with 4.7% uranyl acetate, the samples were embedded in epoxy resins and cut by an ultramicrotome. The ultrathin sections were then contrasted with uranyl acetate and lead citrate and analyzed using transmission electron microscopy. The fractional volume of lipid droplets, autophagic vesicles containing lipid droplets, and lipolysosomes was determined using the double "coherent point" grid with dots distributed at two different densities. Results: While there was no difference in the fractional volumes of lipid droplets and autophagic vesicles containing lipid droplets, the fractional volume of lipolysosomes was significantly higher in the lymphocytes of T2DM patients with hyperlipidemia compared to healthy individuals (p &lt; 0.05). Conclusion: A higher fractional volume of lipolysosomes revealed in the lymphocytes of T2DM patients with hyperlipidemia can be due to an increase in the activity of these organelles, as well as an overall increase in cellular lipid metabolism in these patients.

APSH-OP-5: MEASURES OF LONG-TERM SYSTOLIC BLOOD PRESSURE VARIABILITY AND THEIR ASSOCIATIONS WITH THE RISK OF INCIDENT TYPE 2 DIABETES MELLITUS

Objective: The present study investigates the association between long-term systolic blood pressure (SBP) variability and the risk of type 2 diabetes mellitus (T2DM) by using different indicators of the variability including standard deviation (SD), coefficient of variation (CV), maximum and minimum difference (MMD), root mean square error (RMSE), variability independent of the mean (VIM), and average real variability (ARV). Design and method: A cohort of 3017 Japanese individuals (2446 male, 571 female) aged 36 to 65 was followed from 2007 through 2019. SD, CV, MMD, RMSE, VIM, and ARV of long term SBP changes were calculated per individual using SBP values obtained consecutively from 2003 to 2007. A multivariable Cox proportional model was applied to estimate hazard ratio (HR) and the corresponding 95% confidence interval (CI) for tertiles of the each variability measure, SD, CV, MMD, RMSE, VIM, and ARV, adjusted for age, sex, smoking status, regular exercise, family history of diabetes, sleep disorders, sodium intake, body mass index (BMI), BMI slope, fasting blood glucose (FBG), and 2007 SBP. Results: Of the variability measures examined, the highest RMSE tertile compared to the lowest was significantly associated with T2DM incidence (multivariable-adjusted HR: 1.79, 95% CI: 1.15–2.78). Also, the highest ARV tertile compared to the lowest was associated with T2DM incidence (multivariable-adjusted HR: 1.54, 95% CI: 1.00–2.35). The SD, CV, MMD and VIM were not significantly associated with T2DM incidence independent of the covariates. Conclusion: This study revealed that long-term SBP variability is possibly an independent risk factor for the future occurrence of T2DM, and such property can only be measured by either RMSE or ARV.

EFFECTIVENESS OF PLANT-BASED DIET ON REDUCING THE RISK OF TYPE 2 DIABETES MELLITUS: A LITERATURE REVIEW

Prevalence of Type 2 Diabetes Mellitus (T2DM) disease in Indonesia is still classified as high. Dietary pattern is a factor that affects the occurrence of T2DM, hence patients' dietary pattern must be monitored to avoid further health complications. One of the interventions that can be applied is a plant-based diet, with a consumption pattern of plant-food such as fruit, vegetable, nut, and seed. The aim of this literature study is to identify the effectiveness of plant-based diet in patients with T2DM. This study was conducted using literature review method that resulted in six relevant journals within the last ten years from Google Scholar, PubMed/Medline, Science Direct, and Wiley Online Library. The results of this study show that a plant-based diet affects weight loss, body mass index, blood glucose (HbA1C, fructosamine, fasting plasma glucose), and hormones (insulin, GLP-1, PYY, PP, amylin). It proves that plant-based diets have a positive impact on people with T2DM patients.

Kinship analysis of type 2 diabetes mellitus familial aggregation in Taiwan

BackgroundFamily disease history plays a vital role in type 2 diabetes mellitus (T2DM) risk. However, the familial aggregation of T2DM among different kinship relatives warrants further investigation. MethodsThis nationwide kinship relationship study collected 2000–2016 data of two to five generations of the Taiwanese population from the National Health Insurance Research Database. Approximately 4 million family trees were constructed from the records of 20, 890, 264 Taiwanese residents during the study period. T2DM was diagnosed on the basis of ICD-9-CM codes 250.x0 or 250.x2, with three consecutive related prescriptions. The Cox proportional hazard model was used for statistical analysis. ResultsCompared with their counterparts, individuals who had first-degree relatives with T2DM were more likely to develop T2DM during the follow-up period (hazard ratio [HR], 2.37–27.75), followed by individuals who had second-degree relatives with T2DM (HR, 1.29–1.88). T2DM relative risk was higher in those with an affected mother than in those with affected father. The HR for T2DM was 20.32 (95%CI = 15.64–26.42) among male individuals with an affected twin brother, whereas among female individuals with an affected twin sister, it was 60.07 (95%CI = 40.83–88.36). The HRs presented a dose–response relationship with the number of affected family members. ConclusionThe study suggests a significant familial aggregation of T2DM occurrence; these findings could aid in identifying the high-risk group for T2DM and designing early intervention strategies and treatment plans.

Comparison of Effect of Exercise on Insulin Sensitivity of Overweight Normoglycemic Offspring of T2DM Parents and Non-Diabetic Parents

Background: The primary causes of Type 2 Diabetes Mellitus (T2DM) are largely unknown but insulin insensitivity has been reported to be a risk factor for the T2DM through the alteration of insulin sensitivity pattern. There is paucity of studies on the effect of exercise on occurrence of T2DM in offspring of diabetic parents in our population. Objectives: This study was designed to assess the effect of exercise on insulin sensitivity (IS) on offspring of T2DM parents compared with offspring of non-diabetic parents. Design: This study involved 60 offspring of T2DM parents attending University College Hospital, Ibadan and 60 offspring of non-diabetic parents who are undergraduate students of the University of Ibadan, Nigeria. Participants were randomly assigned into two groups. Each participant followed a protocol of graded exercise using ‘‘tummy trimmer’’ everyday spending 45 minutes daily for 24 weeks. Blood samples were obtained after an overnight fasting for determination of insulin sensitivity using standard methods at baseline and at 24 weeks. Data were analyzed using descriptive statistic and student t test with significance at p&lt;0.05). Results: The most populated aged group was 26 to 35 years of which 47.3% (n=26) were OODP and 52.7% (n=29) were OONDP. However, all subjects were overweight with mean BMI of OODP and OONDP (29.30kg/m2±0.71 versus 26.37kg/m2±0.88) p=.0.035. Significantly, total insulin sensitivity between the two groups increased after 6 months of exercise p=0.045(3.36µ /l±0.24 versus 3.48µ /l±0.24). Conclusions: Male subjects tend to have higher insulin sensitivity than females.

EVALUATION OF RED BLOOD CELL INDICES IN TYPE 2 DIABETES MELLITUS IN SULAYMANIYAH CITY, KURDISTAN REGION, IRAQ

Background &#x0D; Type 2 diabetes mellitus (T2DM) accounts for more than 90% of all diagnosed cases of diabetes. Earlier reports described an independent association of haematological indices, such as red blood cells (RBCs), haemoglobin (Hb), hematocrit (Hct), mean corpuscular haemoglobin (MCV), platelet count (Plt), and white blood cell count (WBC) with the risk of occurrence of T2DM.&#x0D; Objectives &#x0D; To evaluate the relationship between T2DM and red cell indices.&#x0D; Patients and Methods&#x0D; The current cross-sectional study recruited 400 patients with T2DM who were referred to the Diabetic Center in Sulaimani city, Northern Iraq, from November 2018 to March 2019 and 200 healthy blood donors who donated from March to April 2019 to the Sulaimani Blood Bank Center. The required data were collected from both groups, and relevant haematological tests and biochemical analyses were performed. &#x0D; Results&#x0D; Anemia was found in 8% of the patients giving higher rates among the females. Normocytic anaemia was observed in (82.8%) of the patients. Half of the patients had a high level of RBC counts, which correlates significantly with high HbA1c (p=0.005). The prevalence of pre-diabetic and diabetes was 15.5% among healthy blood donors. Patients with T2DM and donation experience showed lower HbA1c levels than those without blood donation (p&lt;0.05). &#x0D; Conclusion&#x0D; Normocytic anaemia is the most common type in patients with T2DM. Patients with a high level of RBC count might be worth screening for T2DM. A high frequency of pre-diabetic and diabetic among asymptomatic healthy blood donors was observed.