Occurrence Of Type 2 Diabetes Mellitus Research Articles

1073-P: Incidence of Type 2 Diabetes Mellitus in a Cohort of Transgender Persons

Introduction: Risk of type 2 diabetes mellitus (T2DM) in transgender persons is an area of clinical and research importance. The objective of this analysis was to examine occurrence of T2DM in a cohort of transgender persons receiving gender affirming hormone therapy. Methods: The current analysis uses data from an electronic health record-based cohort study of persons 12 years and older enrolled in three integrated health care systems. The cohort included 3271 transfeminine members matched to 32,366 cisgender women and 32,349 cisgender men, and 2778 transmasculine members matched to 27,422 cisgender women and 27,391 cisgender men. Matching was based on race/ethnicity, year of birth, study site, and calendar year of membership based on the index date (first evidence of transgender status). Cohort ascertainment spanned nine years from 2006 through 2014 and follow up extended through 2016. Data on T2DM incidence were analyzed using Cox proportional hazard models whereas prevalence was compared using logistic regression; all analyses were adjusted for BMI. Type 1 diabetes cases were excluded from the analysis. Results: Incidence of T2DM was similar across all groups overall and in the analyses limited to a subcohort of transgender members receiving gender affirming hormone therapy. At baseline, there was a significant difference in the prevalence of T2DM in the transfeminine cohort versus reference cisgender men (odds ratio 1.80, 95% CL: 1.01 to 3.21, p-value 0.05). No significant differences in prevalence were found across the remaining comparison groups. Conclusion: Transgender people do not appear to be at higher risk for T2DM compared to their cis-gender counterparts regardless of hormone therapy receipt. Disclosure N. Islam: None. M. Goodman: None.

Role of FoxO1 in regulating autophagy in type 2 diabetes mellitus (Review).

Type 2 diabetes mellitus (T2DM) is a major chronic disease that is characterized by pancreatic β-cell dysfunction and insulin resistance. Autophagy is a highly conserved intracellular recycling pathway and is involved in regulating intracellular homeostasis. Transcription factor Forkhead box O1 (FoxO1) also regulates fundamental cellular processes, including cell differentiation, metabolism and apoptosis, and proliferation to cellular stress. Increasing evidence suggest that autophagy and FoxO1 are involved in the pathogenesis of T2DM, including β-cell viability, apoptosis, insulin secretion and peripheral insulin resistance. Recent studies have demonstrated that FoxO1 improves insulin resistance by regulating target tissue autophagy. The present review summarizes current literature on the role of autophagy and FoxO1 in T2DM. The participation of FoxO1 in the development and occurrence of T2DM via autophagy is also discussed.

Role of TLR4/MyD88/NF-κB signaling in heart and liver-related complications in a rat model of type 2 diabetes mellitus.

AimsTo analyze expression of members of the Toll-like receptor (TLR)4/myeloid differentiation primary response 88 (MyD88)/nuclear factor (NF)-κB signaling pathway in the heart and liver in a rat model of type 2 diabetes mellitus (T2DM). Our overall goal was to understand the underlying pathophysiological mechanisms.MethodsWe measured fasting blood glucose (FBG) and insulin (FINS) in a rat model of T2DM. Expression of members of the TLR4/MyD88/NF-κB signaling pathway as well as downstream cytokines was investigated. Levels of mRNA and protein were assessed using quantitative real-time polymerase chain reaction and western blotting, respectively. Protein content of tissue homogenates was assessed using enzyme-linked immunosorbent assays.ResultsDiabetic rats had lower body weights, higher FBG, higher FINS, and higher intraperitoneal glucose tolerance than normal rats. In addition, biochemical indicators related to heart and liver function were elevated in diabetic rats compared with normal rats. TLR4 and MyD88 were involved in the occurrence of T2DM as well as T2DM-related heart and liver complications. TLR4 caused T2DM-related heart and liver complications through activation of NF-κB.ConclusionsTLR4/MyD88/NF-κB signaling induces production of tumor necrosis factor-α, interleukin-6, and monocyte chemoattractant protein-1, leading to the heart- and liver-related complications of T2DM.

Risk of type 2 diabetes is increased in nonobese women with polycystic ovary syndrome: the National Health Insurance Service-National Sample Cohort Study

To investigate the relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) in Korean women. Longitudinal case-control study. Not applicable. PCOS patients aged 15 to 44 years (n = 1,136) and control individuals (n = 5,675), matched 1:5 by age group, income, and region of residence. Not applicable. The occurrence of T2DM. In the PCOS and control groups, 15.7% and 14.4%, respectively, were obese (body mass index ≥25 kg/m2). The incidence rate of T2DM was 15.84/1,000 and 5.80/1,000 person-years in the PCOS and control groups, respectively. The unadjusted hazard ratio (HR) of T2DM in women with PCOS was 2.6-fold higher than that in control individuals. Women with PCOS still had a higher HR of T2DM than did control individuals after adjustment for body mass index, family history of T2DM, physical exercise level, and total cholesterol. PCOS was significantly associated with T2DM in women both with and without obesity. PCOS is independently associated with an increased incidence of T2DM in both obese and nonobese women. Screening for T2DM should be considered for both obese and nonobese women with PCOS in Korea.

Association of adiponectin & leptin with insulin resistance in type-2 diabetes

Indian phenotype having greater abdominal adiposity, higher waist circumference (WC) & lower body mass index (BMI), thereby making the indians more prone to diabetes and it’s complications. Type-2 diabetes mellitus (T2DM) worldwide known for its morbidity and mortality. Recent studies have demonstrated that the abnormal levels of adipocytokines (Adiponectin, leptin) may contribute to Insulin resistance (IR) and T2DM.The present study aimed to analyze circulatory levels of Adiponectin & Leptin with Insulin Resistance in study subjects compared with control subject & Type-2 diabetes mellitus (T2DM).A total 120 T2DM patients and 120 healthy subjects aged between 30 and 60 years who were Non-diabetic, Non-hypertensive and having no family history of hypertension visiting to Medicine OPD were included in study. Parameters such as age, sex, anthropometric measures and biochemical indicators like fasting and postprandial blood sugar, lipid profile, adiponectin, leptin, fasting insulin, HOMA-IR & systolic and diastolic blood pressure were determined & compared with control subjects.Adiponectin levels were reported significantly lower in T2DM group whereas Leptin levels were significantly higher in T2DM group compared to non-diabetics group (P ≤ 0.001) in both genders.Adiponectin & Leptin levels are used as an important clinical biomarkers for T2DM and obesity. IR, Adiponectin and Leptin can be used as cut off to predict the occurrence of T2DM.

Sex Hormone-Binding Globulins and Testosterone Levels as a Risk Marker for Type 2 Diabetes Mellitus among Postmenopausal Women.

Background:Endogenous sex hormones and sex hormone-binding globulins (SHBG) determine the risk of occurrence of Type 2 diabetes mellitus (T2DM) in postmenopausal (PM) women.Aims:To investigate the association between sex hormones (estradiol and testosterone) and SHBG with plasma glucose, fasting insulin levels, HbA1c, and homeostasis model assessment insulin resistance (HOMA-IR) and also to investigate independent role of sex hormones in the occurrence of T2DM among PM.Settings and Design:Cross-sectional case–control study.Subjects and Methods:The present study was conducted in Endocrinology department Guwahati, Medical College, Assam, India. The participants included cases – PM women with T2DM (n = 100) and controls – Healthy PM women (n = 86). The medical history, clinical examination, and investigations including total testosterone, serum estradiol, SHBG, free testosterone index, high sensitivity C-reactive protein (hs-CRP), lipid profile, fasting insulin, fasting plasma glucose (FPG), and postprandial plasma glucose (PPPG) were done and analyzed. HOMA-IR was calculated.Statistical Analysis:Pearson correlation between sex hormone level and SHBG with plasma glucose, HbA1c, fasting insulin, hs-CRP, and HOMA-IR was seen. Multivariance logistic analysis was done to find the independent association between sex hormones/SHBG and the occurrence of T2 DM. P < 0.05 was considered statistically significant.Results:Among the cases, a significant positive correlation was found between total testosterone/free testosterone index with waist circumference, FPG PPPG, HbA1c, fasting insulin, and HOMA-IR, and a significant negative correlation was found between SHBG and FPG, PPPG, HbA1c, fasting insulin, and HOMA-IR (P < 0.01). The logistic analysis showed total testosterone levels and SHBG are independently associated with the occurrence of T2 DM among PM (P < 0.01).Conclusion:SHBG and testosterone levels in PM can be a risk marker for the development of T2DM.

Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection.

The prevalence of various comorbidities continue to rise in aging persons living with HIV-1 infection (PLWH), and our study here aimed to assess the rates and correlates of incident type 2 diabetes mellitus (T2DM) in PLWH from a retrospective, southeastern U.S. cohort. Based on electronic health records, we examined patient demographics, body mass index (BMI), HIV-1-related outcomes, hepatitis C virus co-infection, common comorbidities (e.g. shingles and asthma), usage of protease inhibitors, and usage of statins as potential correlates for T2DM occurrence. Among 3,975 PLWH with ≥12 months of follow-up between January 1999 and March 2018, the overall rate of incident T2DM was 135 per 10,000 person-years, almost 2-fold higher than the rate reported for the general U.S. population. In multivariable models (354 T2DM patients and 3,617 control subjects), sex, BMI, nadir CD4+ T-cell count, HIV-1 viral load (VL) and duration of statin use were independent correlates of incident T2DM (adjusted P <0.05 for all), with clear consistency in several sensitivity analyses. The strongest associations (adjusted odds ratio/OR >2.0 and P <0.0001) were noted for: i) statin use for ≥6 months (OR = 10.2), ii) BMI ≥30 kg/m2 (OR = 3.4), and iii) plasma VL ≥200 copies/ml (OR = 2.2). Their collective predictive value was substantial: the C-statistic for area under the receiver operating characteristics curve was 0.87 (95% CI = 0.84-0.91), showing close similarity between two major racial groups (C-statistic = 0.87 for African Americans and 0.91 for European Americans). Overall, these findings not only establish a promising algorithm for predicting incident T2DM in PLWH but also suggest that patients who are obese and use statins should require special consideration for T2DM diagnosis and prevention.

The Association of Antioxidants Gene Polymorphisms (SOD2 Ala16Val, GPx1 Pro198Leu, GSTP1 Ile105Val, and Cat −21 A/T) and Risk of Type 2 Diabetes Mellitus

BACKGROUND: Antioxidant gene polymorphism is one of the genetic risk factors associated with type 2 diabetes mellitus (T2DM) incidence.&#x0D; AIM: This study was to analyze the association of superoxide dismutase 2 (SOD2) Ala16VAl, glutathione peroxidase (GPx1) Pro198Leu, glutathione S-transferase Pi1 (GSTP1) Ile105Val, and Cat −21 A/T gene polymorphisms and risk of T2DM.&#x0D; METHODS: We genotyped deoxyribonucleic acid of 120 T2DM patients and 80 healthy control by polymerase chain reaction and restriction fragment length polymorphism method, using a specific restriction enzyme.&#x0D; RESULTS: This study showed that the Val/Val of SOD2 was significantly associated with an increased risk of T2DM compared to the Ala/Ala+Ala/Val (p = 0.011; odds ratio [OR] = 2.220; confidence interval [CI] = 1.234–3.992). The TT genotype of Cat gene was also significantly associated with an increased risk of T2DM compared to the AA genotype (p = 0.027; OR = 5.000; CI = 1.079–23.176) and TT genotype to the AA+AT genotype (p = 0,030; OR = 4.738; CI = 1.039–21.600). However, there was no difference in all genetic models of GPx1 Pro198Leu and GSTP1 Ile105Val gene polymorphisms (p &gt; 0.05).&#x0D; CONCLUSION: This study indicates that the Val/Val under the recessive model of SOD2 gene also TT genotype under the co-dominant model of Cat gene and TT genotype under the recessive model of Cat gene were associated with risk factors for T2DM occurrence.

Risk of type 2 diabetes mellitus by antimuscarinic agents among adult females receiving care in the military health system.

To explore patterns of antimuscarinic medication as a risk factor for type 2 diabetes mellitus (T2DM). This is a retrospective cohort study of females 18 years or older within the Military Health System from 2006 to 2016. Administrative and claims data were used to select patients who initiated therapy with tolterodine, fesoterodine, oxybutynin, darifenacin, solifenacin, or trospium. Patients with no documented history of T2DM were followed for the occurrence of T2DM, the end of the study or loss of eligibility. Rates of T2DM were calculated for the overall population, by duration of therapy and by individual drugs. Crude and adjusted Cox proportional hazards were calculated to assess differences by duration of use and specific muscarinic antagonist. Over 2.6 million antimuscarinic prescriptions were dispensed to 241 829 females (mean age/SD, 62 ± 18 years). Patients exposed to M3 selective antagonists had highest risk of developing T2DM compared to those exposed to nonselective antagonists. Using oxybutynin, a nonselective antagonist as a comparator, adjusted rate ratios of T2DM were 57% (HR 1.57, 95%CI 1.48-1.67) and 29% (HR 1.29, 95%CI 1.24-1.35) significantly higher for darifenacin and solifenacin, respectively (both M3 selective). We found exposure to M3 selective antagonists darifenacin and solifenacin had the highest risk of developing T2DM compared to nonselective antagonist oxybutynin. This is supported by well described physiologic mechanisms and may allow for more informed prescribing decisions, particularly if minimizing risk of T2DM is a priority.

The association of statins for secondary prevention with progression to diabetes in patients with prediabetic state after coronary artery bypass graft surgery: A retrospective cohort study

AimDespite proven benefits of statins for secondary prevention of coronary artery diseases, their diabetogenic effect is still controversial. We aimed to examine the occurrence of type 2 diabetes mellitus (T2DM) in prediabetic patients after coronary artery bypass grafting (CABG). MethodsThe retrospective cohort population comprised of post-CABG patients who were prediabetic at the time of surgery and were taking statins. Patients were categorized into the high- and low-intensity statin regimens according to the commonly used dose during the follow-up. Moreover, we calculated the cumulative dose (milligrams*days) by taking into account that patients were on different doses of statins during different periods of time. We observed patients for occurrence of T2DM or major adverse cardiovascular events (MACE) as a composite of death, myocardial infarction, cerebrovascular accident, and hospitalization for unstable angina or heart failure. ResultsWe studied 819 patients for a median of 37.8 months after CABG. T2DM occurred in 8.1% (n = 66). The rate of T2DM development was not different between the high- and low-intensity groups (P = 0.715) and also according to the cumulative dose (P = 0.962). Furthermore, we found no association (P = 0.938) even after adjustment for confounders including age, sex, body mass index, alcohol use, history of hypertension and hyperlipidemia, and family history of T2DM. Moreover, high- rather than low-intensity statin regimen was correlated with a lower occurrence of MACE (P = 0.027), even after adjustment for confounders (P = 0.015). ConclusionsIn prediabetic post-CABG patients, treatment with statins was not associated with the development of T2DM and reduced occurrence of MACE after 37 months.

Relationships between microvascular complications of diabetes mellitus and levels of macro and trace elements.

The aim of this study was to determine relationships between microvascular complications of type 2 diabetes mellitus (T2DM) and trace element levels measured by ICP-MS. One hundred eighteen patients with T2DM (age: 30-65 years) and 40 control subjects were included in the study. The T2DM patients were divided into three groups according to their types of microvascular complications. Patients in group 1 (N.=40) had no microvascular complications. Group 2 included 38 patients with only diabetic retinopathy. Group 3 included 40 patients with diabetic retinopathy and nephropathy. Trace elements, including chromium (Cr), copper (Cu), and zinc (Zn), were measured by inductively coupled plasma mass spectrophotometry (ICP-MS). Mg levels analyzed by ICP-MS were lower in patients with T2DM than in healthy subjects. Additionally, Mg level of 2.1 mg/dL or less was found to be predictive for risk of occurrence of T2DM with no microvascular complications. Cr levels were significantly lower in T2DM patients with diabetic retinopathy and diabetic nephropathy than in T2DM patients with no microvascular complications. Additionally, levels of Cr were much lower significantly in group 3 than in group 2. The predictive value of Cr levels (area under the curve [AUC]=0.734, P=0.007) for occurrence of diabetic retinopathy was 15.2 μg/L (sensitivity = 70%; specificity = 60.5%). This study showed an association between especially low Mg and Cr levels measured via ICP-MS and microvascular complications in patients with T2DM.

Type 2 diabetes prevalence in Pakistan: what is driving this? Clues from subgroup analysis of normal weight individuals in diabetes prevalence survey of Pakistan.

Type 2 diabetes mellitus (T2DM) is a global health tissue. We determined factors relating to the likelihood of developing T2DM in normal BMI individuals. This was a cross-sectional community-based representative survey, of people aged ≥20 years in Pakistan, using HBA1c as the screening tool. The prevalence of T2DM/prediabetes in people having normal BMI together with associated risk factors was estimated. Of 6824 normal BMI individuals, there was still a high prevalence of T2DM 14.92% and in underweight at 10.14% (overall prevalence 16.96%). Corresponding rates for prediabetes for the normal BMI category: 9.79% and underweight 8.99%. Multivariate logistic regression modeling for normal BMI individuals, showed a significantly increased risk of T2DM with increasing age (odds ratio [OR] 2.1, 3.3, 4.5 and 4.8, P < 0.001 for 31-40, 41-50, 51-60 and 61 years and above respectively, compared to age decade 20-30 years). Similarly, there was a significantly high risk of T2DM with lower education level [OR for no vs graduate 2.4, 95% confidence interval (CI) 1.5-3.8]. There was a significantly increased risk of T2DM in individuals having a positive family history [OR 4.3 (95% CI 7.0-11.5)]. Overall the influence of overweight/obese on T2DM occurrence (20% increased risk) was much less than in other regions of the world. There are higher than expected rates of T2DM/prediabetes in Pakistani ethnicity normal BMI individuals. Targeted screening of older individuals with historical lack of educational opportunity, with a family history of T2DM even if of normal BMI may result in a significant benefit in the Pakistan population.

The association between melatonin receptor 1B gene polymorphisms and type 2 diabetes mellitus (T2DM) in Chinese populations: a meta-analysis.

Type 2 diabetes mellitus (T2DM) is associated with a large number of genetic variants of melatonin receptor 1B (MTNR1B), but the results of studies involving different racial groups have been inconsistent. Thus, we carried out a meta-analysis to evaluate the correlation between the MTNR1B variants and T2DM in the Chinese population. A systematic search was conducted of English-language databases including PubMed, Embase, and Medline, and Chinese-language databases including China National Knowledge Infrastructure (CNKI), Wanfang Database, and CQVIP to collect relevant articles published up to January 31, 2020. Count data were pooled using odds ratio (OR) and 95% confidence interval (CI), and the analysis was performed using the "meta" package of the R3.5.1 software. Nine articles involving 10,127 subjects in the T2DM group and 10,885 subjects in the healthy control group were entered into the final analysis. Four articles reported the rs1387153 variant of the MTNR1B gene in Chinese populations. Meta-analysis showed there to be no correlation between the C-allele and TT genotype and the occurrence of T2DM. However, a subgroup analysis based on the HardyWeinberg equilibrium (HWE) revealed that the frequency of the CC genotype was significantly lower in the T2DM group than in the control group (OR: 0.88; 95% CI: 0.78, 1.00; P=0.049). Seven articles reported the rs10830963 variant of the MTNR1B gene among Chinese populations. Meta-analysis discovered that the G-allele was correlated with the T2DM occurrence. The frequency of the G-allele in the T2DM group was 1.07 times that in the control group (95% CI: 1.02, 1.12). The GG genotype was associated with the occurrence of T2DM, with its frequency in the T2DM group 1.15 times that in the control group (95% CI: 1.05, 1.25) (P<0.05); however, there was no correlation between the CC genotype and T2DM. There is a correlation between the CC genotype of the rs1387153 variant in the MTNR1B gene and T2DM in the Chinese population, although this finding needs to be verified in studies with large sample sizes. The G-allele and GG genotype of the rs10830963 variant in the MTNR1B gene are associated with the occurrence of T2DM.

Utilização do Finnish Diabetes Risk Score (FINDRISC) como ferramenta para identificação, prevenção e conscientização da diabetes mellitus em adultos da cidade de Santos

Avaliar a funcionalidade da ferramenta Finnish Diabetes Risk Score (FINDRISC) na identificação, prevenção e conscientização da Diabetes mellitus tipo2 (DM2) na cidade de Santos. Trata-se de um estudo transversal, analítico e descritivo. Foram avaliadas 96 pessoas e os participantes foram entrevistados, realizou-se a aferição da pressão arterial (PA), medições antropométricas, glicemia capilar de jejum (GCJ) e analisados os resultados obtidos no FINDRISC. Para análise estatística, aplicaram-se nos dados a análise de variância e teste do qui-quadrado. A prevalência de DM2 foi de 17%. Entre os fatores de risco modificáveis as maiores prevalências foram: Circunferência abdominal alterada (86%), IMC&gt;25kg/m² (75%), PA alterada (57%) e GCJ&gt;100mg/dL (48%). A maior associação para ocorrência de DM2 foi “antecedentes familiares” com aumento de risco em 3,3 vezes (P&lt;0,02). Dos entrevistados que afirmaram não ter diagnóstico de DM2, 40% estava com o valor de GCJ acima de 100 mg/dL e 7,5% da amostra com valores acima de 126mg/dL sendo que destes, 85% apresentavam risco elevado em desenvolver DM2 pela pontuação FINDRISC. Os resultados demonstram a eficácia da ferramenta FINDRISC em identificar DM2 e a necessidade da realização das campanhas preventivas ou de promoção de saúde para o rastreamento e orientação de pessoas com elevado risco.

Vitamin D Level Status and Hypertension among Elderly Iraqi People in Al Hillah City

Background: Vitamin D has different biological actions in the body . Vitamin D has the pleiotropic effectsin multiple organ systems. Vitamin D (vit D) deficiency has been found to have an inverse relationship withthe occurrence of type-2 diabetes mellitus (DM). The aim of this study was to assess the vit D level in type-2diabetic patients.Objective: To identify Vitamin D level and its correlate with type2 diabetes mellitus among old adults.Methodology: This was across sectional descriptive observational study included a non-probability(convenient sample) of elders (&gt;65 years both women and men) in Hilla City, Babylon province, the periodof the study started from the first of January through August 2019, the sample size was calculated accordingto the sample size calculation equation with 95% confidence level, 300 elderly people were participatedvoluntarily in this study after explaining the objective of the study by the researcher, the response rate inthis study 100%. This study was approved by the Ethics Committee of College of nursing - University ofBabylon, a pretested questionnaire was used to interview the participants after obtaining their verbal consents,the sample included old adults, apparently healthy &amp; not receiving vitamin D supplement, serum levelof Vitamin D that made by chemo immunoassay method (maglumi instrument). Data about demographiccharacteristics, drug uses, number of chronic diseases, as well as measurement of mean blood sugar of eachparticipant were done single handy by the researcher. Blood sugar was measured using electronic system,blood sugar more than 170mg/dl considered diabetes in this study or those who diagnosed previously asdiabetes (type 2) and taking anti diabetic drugs. Vitamin D levels are divided into three categories .deficient&lt; 20ng/ml, insufficient between 23-29ng/ml and normal level 30-100 ng/ml 27 . Data were analyzed by usingthe (spss) package version 23. The chi-square test was used to test the associations between variables. Theassociation considered statistically significant when the P-value is less than 0.05.Results: The study included 300 participants, most of the study sample had either insufficiency or deficiencyof Vitamin D level. Diabetic elders in this study had significant low serum Vitamin D level (both deficiencyand insufficiency of vitamin) as compared to healthy group, this difference was statistically significantp&lt;0.05.Conclusion: There was a significant inverse relationship between vitamin D level and type 2 diabetesmellitus.

Significant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH

Non-alcoholic fatty liver disease (NAFLD) could play a catalytic role in the development of metabolic comorbidities, although the magnitude of this effect in metabolically healthy patients with NAFLD remains unclear. We assessed the role of biopsy-proven NAFLD on the risk of developing type 2 diabetes mellitus (T2DM) and other metabolic comorbidities (arterial hypertension [AHT], and dyslipidemia) in metabolically healthy patients. We included 178 metabolically healthy-defined by the absence of baseline T2DM, AHT, dyslipidemia-patients with biopsy-proven NAFLD from the HEPAmet Registry (N= 1,030). Hepamet fibrosis score (HFS), NAFLD fibrosis score, and Fibrosis-4 were calculated. Follow-up was computed from biopsy to the diagnosis of T2DM, AHT, or dyslipidemia. During a follow-up of 5.6 ± 4.4 years, T2DM occurred in 9% (16/178), AHT in 8.4% (15/178), low HDL in 9.6% (17/178), and hypertriglyceridemia in 23.6% (42/178) of patients. In multivariate analysis, significant fibrosis predicted T2DM and AHT. Independent variables related to T2DM appearance were significant fibrosis (HR 2.95; 95% CI 1.19-7.31; p= 0.019), glucose levels (p= 0.008), age (p= 0.007) and BMI (p= 0.039). AHT was independently linked to significant fibrosis (HR 2.39; 95% CI 1.14-5.10; p= 0.028), age (p= 0.0001), BMI (p= 0.006), glucose (p= 0.021) and platelets (p= 0.050). The annual incidence rate of T2DM was higher in patients with significant fibrosis (4.4 vs. 1.2 cases per 100 person-years), and increased in the presence of obesity, similar to AHT (4.6 vs. 1.1 cases per 100 person-years). HFS >0.12 predicted the risk of T2DM (25% [4/16] vs. HFS <0.12 4.5% [4/88]; logRank 6.658, p= 0.010). Metabolically healthy patients with NAFLD-related significant fibrosis were at greater risk of developing T2DM and AHT. HFS >0.12, but not NAFLD fibrosis score or Fibrosis-4, predicted the occurrence of T2DM. Patients with biopsy-proven non-alcoholic fatty liver disease and significant fibrosis were at risk of developing type 2 diabetes mellitus and arterial hypertension. The risk of metabolic outcomes in patients with significant fibrosis was increased in the presence of obesity. In addition to liver biopsy, patients at intermediate-to-high risk of significant fibrosis by Hepamet fibrosis score were at risk of type 2 diabetes mellitus.

&lt;p&gt;Khat Chewing and Type 2 Diabetes Mellitus&lt;/p&gt;

ObjectiveKnowledge about the effects of khat chewing on type 2 diabetes mellitus (T2DM) development and glycemic control is very sparse. Emerging data suggest that khat chewing may increase the risk of T2DM occurrence. Therefore, this study aimed to measure the prevalence of khat chewing in Saudi people with T2DM in Jazan, Saudi Arabia and to determine the association of khat chewing with T2DM development and glycemic control in T2DM.MethodsThis is an analytical, cross-sectional study that included 472 Saudi participants selected randomly from primary healthcare centers in Jazan, Saudi Arabia. A chi-square test and logistic regression were performed in the statistical analysis.ResultsThe prevalence of khat chewing in Saudi patients with T2DM in Jazan was 29.3%. After adjusting for covariates, khat chewing was significantly associated with T2DM (odds ratio 3.5), indicating that khat chewers had a more than three times higher risk of developing T2DM than those who do not chew khat. However, there was no association between khat chewing and glycemic control in T2DM.ConclusionKhat chewing was highly prevalent in Saudi people with T2DM in Jazan, Saudi Arabia. There was an association between khat chewing and the development of T2DM. Establishing the causal association of khat chewing with T2DM development and glycemic control and clarifying the biological role of khat in T2DM are important aims for future studies.

Relationships among resistin, adiponectin, and leptin and microvascular complications in patients with type 2 diabetes mellitus

ObjectiveTo investigate the relationships among serum resistin, adiponectin, and leptin and microvascular complications in patients with type 2 diabetes mellitus (T2DM).MethodsA total of 120 patients with T2DM were divided into non-microangiopathy and microangiopathy groups. Sixty age- and sex-matched healthy subjects were used as a normal control (NC) group. Body height, body mass, waist circumference, and blood pressure were determined, and waist/hip ratio (WHR), body mass index, blood glucose, lipids, resistin, leptin, adiponectin, free fatty acids (FFA), high-sensitivity C-reactive protein (hs-CRP), fasting insulin, hemoglobin A1c, and homeostatic model assessment of insulin resistance (HOMA-IR) were compared among the three groups.ResultsSerum levels of resistin, leptin, FFA, and hs-CRP were significantly higher and levels of adiponectin were significantly lower in patients in the non-microangiopathy (n = 60) and microangiopathy groups (n = 60) compared with the NC group (n = 60). Serum resistin and leptin levels in patients with T2DM were positively correlated with WHR, hs-CRP, FFA, HOMA-IR, and triglycerides, but negatively correlated with high-density lipoprotein-cholesterol (HDL-C). Serum adiponectin levels in patients with T2DM were negatively correlated with WHR, hs-CRP, FFA, HOMA-IR, and triglycerides, but positively correlated with HDL-C.ConclusionSerum resistin, adiponectin, and leptin levels correlate with the occurrence of T2DM and microvascular complications.

Effect of exercise on basal insulin levels in normoglycaemic offspring of patients with Type 2 Diabetes mellitus

Background: Low basal insulin level is a risk factor for Type 2 Diabetes mellitus (T2DM) as a result of altered insulin sensitivity pattern. However, it is uncertain if exercise may influence the occurrence of T2DM in the offspring of diabetic parents. Objective: To assess the effect of exercise on basal insulin levels in the offspring of T2DM parents compared with the offspring of non-diabetic parents. Design: The participants were assigned into four groups using a convenience sampling method; 27 Normal-weight Offspring of Non-Diabetic Parents (NONDP), 21 Normal-weight Offspring of Diabetic Parents (NODP), 26 Overweight Offspring of Non-Diabetic Parents (OONDP) and 21 Overweight Offspring of Diabetic Parents (OODP). Each participant followed a protocol of graded exercise using ''tummy trimmer'' everyday spending 30-45 minutes daily for 24 weeks. Blood samples were obtained after overnight fasting for determination of insulin level using standard methods (immunoassay technique) at baseline, six weeks, 12 weeks, 18 weeks and 24 weeks respectively. Results: There were 23/42 males (54.8%) in the study groups and 34/51 females (64.2%) in the control groups. Thirty-one (58.7%) in the control group and 24 (57.1%) in the study group were aged 21-30 years. An increase in insulin levels was recorded at 12 weeks in all groups except in NONDP where the insulin levels decreased. The insulin level change was highest in the NODP (2.25ng/ml) group. Conclusions: Graded exercise improved insulin levels in all test groups. The clinical importance of graded exercise in the prevention of diabetes mellitus among the offspring of diabetic parents may be promising.

Relationship between serum CTRP6 level and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus

Objective To explore the relationship between serum C1q and tumor necrosis factor related protein 6(CTRP6) level and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods A total of 167 patients with newly diagnosed T2DM in the outpatient department of our hospital were recruited from April 2016 to March 2017 and 165 subjects with normal glucose tolerance were used as the control group. The concentrations of CTRP6, interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor α (TNF-α) were determined by ELISA. Results Circulating CTRP6 level was significantly higher in T2DM group than that in control group [(652.54±132.57) vs (521.28±119.93)μg/L, P<0.01] after adjusting age and body mass index (BMI). Overweight/obese subjects revealed higher CTRP6 levels compared with those in lean individuals. In addition, circulating CTRP6 level was positively correlated with BMI, waist circumference, fasting plasma glucose, postprandial 2h plasma glucose, HbA1C, fasting insulin, homeostasis model assessment insulin resistance index (HOMA-IR), triglyceride (TG), IL-6, MCP-1, highly sensitive C-reactive protein (hs-CRP), and TNF-α, while it was inversely correlated with high-density lipoprotein-cholesterol(P<0.01). Multivariate linear regression analysis showed that TG, HOMA-IR, and IL-6 were independent factors for CTRP6 level. After adjusting for potential confounders, CTRP6 remained an independent risk factor for T2DM. Trend test showed that the increase in CTRP6 level was significantly linear with the occurrence of T2DM. The analysis of receiver operating characteristic curves revealed that the area under the curve for circulating CTRP6 to predict T2DM was 0.730. Conclusions CTRP6 may be associated with insulin resistance. Key words: C1q/TNF-related protein-6; Diabetes mellitus, type 2; Inflammation; Insulin resistance