Prediabetic Subjects Research Articles

Factors associated with progression of different prediabetic status to Diabetes: A Community-based cohort study

AimsTo examine the predictive factors associated with the progression of different prediabetic status to diabetes. MethodsA two-year retrospective cohort study was conducted on 5741 participants aged 40 years or older. Finally, 1685 participants with prediabetes defined by IFG (impaired fasting glucose), IGT (impaired glucose tolerance) and CGI (combined IFG and IGT) were included. Logistic regression model was used to evaluate the risk of prediabetes progression to diabetes. ResultsOf the 1685 subjects with prediabetes at baseline, 212 (12.6%) subjects progressed to diabetes and 1473 (87.4%) subjects did not. Logistic regression analysis demonstrated that people with CGI were associated with an increased risk of progressing to diabetes compared to those with IFG (OR, 95% CI: 3.127, 2.047–4.776). Moreover, males, obese people, people with increased BMI and WHR (Waist/ Hip ratio), and hypertension were positively associated with the progression to diabetes, while HOMA-β was negatively associated with the progression to diabetes. ConclusionsSubjects with CGI are prone to progressed to diabetes compared to those with IFG or IGT in middle-aged and older person in China. More attention should be paid to male and obese prediabetic subjects, and measures should be taken to control the increase in their BMI and WHR.

Comparison of Lipid Profile in Prediabetic and Non Prediabetic Adult Off-springs of Type 2 Diabetics Patients: A Cross-sectional Study

Introduction: Lipid abnormality is an important modifiable risk factor associated with the type 2 diabetes mellitus and prediabetes. Dyslipidaemia occurring in diabetic patients, has important role in development of macrovascular atherosclerosis and increases the risk of cardiovascular disease. Furthermore, prediabetes has also been found to be associated with an increased risk for cardiovascular disease. Considering the prevalence and increased risk of cardiovascular disease in diabetes, it is becoming necessary to diagnose prediabetic individuals and assess their lipid profile and prevent them from developing overt diabetes and the further complications. Also, data available on lipid abnormalities in prediabetics is relatively less in the Indian population. Aim: To compare lipid profile in prediabetic and non prediabetic adult off-springs of type 2 diabetics and to evaluate the association between lipid profile and prediabetes. Materials and Methods: This cross-sectional study was conducted on 150 healthy young adult (> 18 years) off-springs of type 2 diabetic patients, willing to participate in the study in Government Medical College and Hospital, Miraj from January 2019 to December 2019. All the relevant information was collected by administering a structured case record form. Fasting blood samples were collected and fasting blood glucose level, lipid profile including Total cholesterol (TC), Triglycerides (TG), Low Density Lipoproteins (LDL), High Density Lipoproteins (HDL), Very Low-Density Lipoproteins (VLDL), were estimated and compared. Data collected was entered in the Microsoft excel (2010), expressed as frequency and mean. Chi-square test and Fisher’s exact test were applied to observe the association between different study parameters. A p-value <0.05 was considered statistically significant. Results: Prevalence of prediabetes was 17.3% (fasting BLS 100 to 125 mg/dL) in age group of 26 to 30 years (26.67%). It was found that occurrence of prediabetes was more in male participants (25.37%) as compared to female participants (10.84%). Association between gender of the participants and occurrence of prediabetes was found to be statistically significant (p-value=0.019). The association between prediabetes and higher TC levels (mean-204.88±47.99 and 152.46±29.35 mg/dL), lower HDL levels (mean-57.65±4.59 and 66.18±6.02 mg/dL), higher LDL levels (mean-94.77±30.71 and 69.57±17.88 mg/dL), higher VLDL levels (mean-128.08±49.96 and 39.52±39.99 mg/ dL) was found to be statistically significant (p-value<0.05) and the association between prediabetes and higher TG levels (mean-48.65±18.45 and 28.18±9.47 mg/dL) was not significant (p-value=0.056). Conclusion: Total cholesterol, LDL, TG, VLDL were significantly raised, whereas HDL was significantly lower in prediabetic subjects as compared to non prediabetic healthy subjects. The association between prediabetes and higher TC levels, lower HDL levels, higher LDL levels, higher VLDL levels was found to be statistically significant (p-value<0.05) and the association between prediabetes and higher TG levels was not significant (p-value=0.056). So, prediabetic individuals, though asymptomatic have significant dyslipidaemia, that puts them at higher risk for developing cardiovascular disease.

A study on adiponectin, uric acid, and C-reactive protein in prediabetic and diabetic subjects

BACKGROUND: Diabetes and prediabetes are always on the rise over the past decade, but little is known about the development of type 2 diabetes mellitus dysfunction in young adults. The study was conducted in prediabetic and diabetic patients in order to belong to an anti-inflammatory hormone adiponectin and pro-inflammatory marker uric acid (UA) in these patients and also to determine the role of these markers in future cardiovascular disease (CVD) risk. MATERIALS AND METHODS: This case–control study was conducted at Rama Medical College and Hospital, Kanpur. Out of 400 participants recruited, 140 subjects were control, 140 were prediabetics, and the remaining 120 were controlled. The detailed history of the patients regarding age, gender, height, weight, and family history regarding obesity and other chronic illnesses was taken. Patients with medical complications or diseases and conditions that may affect levels of inflammatory markers were excluded from the study. The data analysis was done using SPSS 16 and the results were presented as mean ± standard deviation where P < 0.05 has been considered as statistically significant. RESULTS: The adiponectin level was found significantly decreased and C-reactive protein and UA levels were increased in both study groups (prediabetes and diabetes) while comparison was done with control group. Similarly, basic parameters including waist/hip ratio, body mass index, glycated hemoglobin, and fasting blood glucose were increased. CONCLUSION: The study showed that prediabetes and diabetes are diseases of inflammatory origin with a high level of pro-inflammatory molecules. These medications are not only potent risk factors for prediabetes and diabetes but also mediate significant future CVD risk in these patients.

Improvement in the metabolic markers of prediabetic subjects due to the partial substitution of Taiken9 rice by RD43 rice in their daily diet: a randomized clinical trial.

Although RD43 rice is characterized by high amounts of undigestible starch, its potential health benefits for prediabetic individuals remain unknown. Thus, the effect of regular consumption of RD43 rice on the glycemic response, body composition, and metabolic markers was investigated in a sample of 34 participants with prediabetes (aged from 32 to 68 years) who were randomly allocated to either the treatment or the control group. The first were required to consume RD43 rice (Glycemic Index [GI] = 78) containing 14.1 g of undigestible starch daily as a substitute for two meals per day while the second were given the Taiken9 rice (GI = 98) for 12 continuous weeks. The evaluations were performed at baseline, at the end of week 6 and 12, and at follow-up conducted two weeks after the intervention had ended. The results obtained at the week 12 assessment clearly showed a significant decrease in fasting plasma glucose, insulin, HbA1c, and HOMA-IR in the group that consumed RD43 rice. In addition, daily ingestion of RD43 rice markedly reduced body weight, Body Mass Index (BMI), total fat mass, and waist circumference at both week 6 and 12 compared with the baseline. When compared with the controls, the treatment group also exhibited a significant decrease in fasting plasma insulin and HOMA-IR at week 12. However, no significant inter- or intra-group differences in lipid profiles were detected. These findings suggest that RD43 rice could be a potential staple food with the capacity to improve glycemic control and body composition in prediabetic individuals.

Evaluation of Non-HDL-C and Calculated Lipid Profile Ratios among Pre-Diabetic Individuals

Introduction: The worldwide prevalence of diabetes mellitus is rapidly increasing. The major concern is the complexity and mortality that are secondary to the complications of diabetes mellitus. One among the complications is dyslipidaemia which leads to atherosclerotic diseases. Pre-diabetes is a mid-state between non-diabetes and diabetes mellitus. They have a greater chance of progressing into the disease. Dyslipidaemia, a major aetiological factor for atherosclerosis, is also noted in pre-diabetic stage, report studies. This study was a cross-sectional study involving 26 non-diabetic controls, 26 prediabetic and 26 diabetic cases. The participants were of 18-45 years of age. The data was collected over a period of three months. The groups were classified based on their HbA1c concentration. The blood samples were analysed for fasting lipid profile and the parameters, Non-HDL-C, TC/HDL-C and LDL-C/HDL-C obtained by using respective methods. The obtained lipid profile parameters, Non-HDL-C, TC/HDL-Cand LDL-C/HDL-C were found to be increased in pre-diabetic subjects and diabetic subjects when compared to the healthy non-diabetic controls. The parameters also showed a positive correlation and was statistically highly significant among the three groups. There was a positive association observed among the groups for the calculated lipid profile parameters, Non-HDL-C, TC/HDL-C and LDL-C/HDL-C and were found to be directly proportional to HbA1c.

Preliminary Assessment of Glycemic Control and Body Fat Reduction Effects of Terminalia chebula Retz. Extract on Pre-diabetic Subjects

Preliminary Assessment of Glycemic Control and Body Fat Reduction Effects of Terminalia chebula Retz. Extract on Pre-diabetic Subjects

Estimating the Correlation of Ankle Brachial Index with Vascular Risk Factors in Pre-diabetics

Background: Prediabetes is characterized by a long duration of insulin resistance and increased fasting plasma glucose. Among the various risk factors for cardiovascular atherosclerosis and prediabetes, insulin resistance is one of them. Glycemia has been recognized to affect microvascular damage as compared to macrovascular damage. The ankle-brachial index (ABI) is a simple, affordable and non-invasive test as compared to angiography and has been found to have a high sensitivity and accuracy for the diagnosis of PAD, the gold-standard diagnostic method. This index is based on the fact that in healthy people, systolic blood pressure in the legs is typically equal to or marginally greater than in the upper limbs. This study aims to assess the correlation of ABI with vascular risk factors among subjects with Prediabetes like anthropometric measurement like BMI, Waist hip ratio and neck circumference.
 Methods: This will be a observational cross sectional study. The present research will involve a cluster of prediabetic subjects. ABI will be determined for all patients. Anthropometric measurements will be taken and blood investigations will be conducted. All data will be compiled and analyzed with appropriate statistical tests.
 Expected Results: We expect a significant association between prevalence of low ABI in prediabetics and heart problems.
 Conclusion: This research will highlight the adequate clinical and sociological assessment of pre-diabetes patients, including those who have been diagnosed for a long period of time.

Prevalence of Diabetes and Hypertension in Young females of Lahore College for Women University, Lahore

Diabetes and hypertension are non-communicable diseases. Diabetes is a significant cause of early death and debility globally. The objective of the present study is to find out the percentage incidence of diabetes and hypertension in young females of Lahore College for Women University Jail Road, Lahore. This cross-sectional study was conducted, January 2017 to June 2017. It was included 200 subjects. The average age of the population under study was 20 ± 0.17 years. About 4.5% (n=9) of the population was pre-diabetic and all were obese. While, 36% (n=73) of population was suffering from prehypertension and 5% (n=10) with hypertension. Among a total of 83 subjects with elevated systolic blood pressure (SBP), 41 were overweight and obese. According to diastolic blood pressure (DBP) 7% (n=14) of the population was suffering from pre-hypertension and 6% (n=12) with hypertension. 26 subjects had elevated diastolic blood pressure and among these, 20 subjects were overweight and obese. The whole population is divided among 4 groups according to the age groups. Body mass index was moreprevalent in the age group 25-27 years. It is stated that overweight and obesity are strongly associated with diabetes and hypertension. It was concluded that increased BMI was the main predictor of diabetes and hypertension. However no diabetic patient were found in population and the prevalence of pre-diabetic subjects were 4.5 % and according to SBP and DBP 5% and 6 % of the population were hypertensive.

Platelet Indices as Indicator of Diabetic Nephropathy among Patients Attending a Tertiary Care Centre in South-India

Introduction: Diabetes mellitus, a chronic metabolic disease affects various organs of the body on a long-term basis. Studies have been conducted on different aspects of the disease, to understand its complications and to detect them earlier to avoid irreversible damage like nephropathy.
 Aim: The study aims at comparing platelet indices like Plateletcrit (PCT), Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV), with serum creatinine among diabetes, prediabetes patients and non-diabetes controls, to understand the association of the platelet indices and creatinine, an indicator of renal damage.
 Materials and Methods: The cross-sectional study conducted over a period of three months involved 30 non-diabetic controls with normal HbA1c, 30 diabetics and 30 prediabetic subjects, of age group 18-35 years. The groups were classified based on their HbA1c concentration. The blood samples were analyzed for parameters PCT, PDW, MPV, creatinine and HbA1c by their respective methods. The study will guide in understanding the role of platelets in pathogenesis of diabetic nephropathy.
 Results: Platelet indices like Plateletcrit (PCT), Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV) were found to be increased in diabetics and 30 prediabetic subjects than the non-diabetics. The Platelet indices were also correlating with the serum creatinine levels of the three study groups.
 Conclusion: There is a positive association between the Platelet indices and creatinine, in patients with pre-diabetes and diabetes who have the risk of progression to diabetic nephropathy. Hence, the Platelet indices shall be included as early and cost-effective biomarkers of diabetic nephropathy.

ASSOCIATION OF SERUM TNF- A WITH INSULIN RESISTANCE IN PRE-DIABETES AND TYPE 2 DIABETES MELLITUS

Background- First adipocyte derived biomarker is tumor necrosis factor alpha which connect the link between inflammation and diabetes. It expresses m-RNA which is contributing to the development of insulin resistance. However, the relationship between tumor necrosis factor alpha, pre-diabetes and Type2diabetes mellitus is still contradictory and restricted. Material & Methods: This study was hospital based analytical cross-sectional study. Total 900 subjects were distributed into three groups (300 pre-diabetic subjects, 300 type 2 diabetic subjects and 300 healthy subjects) as per ADA criteria. The biochemical parameters as Fasting Blood Glucose, 2-hr glucose (after 75 gm oral glucose intake), HbA1c and fasting insulin were analyzed. HOMA-IR was used to calculate insulin resistance mathematically. Anthropometric measurements were done. Tumor necrosis factor alpha was done by ELISA method. Results: Tumor necrosis factor alpha concentration was significantly increased in patients with type 2 diabetes mellitus and pre-diabetes in comparison to the control group at p value < 0.001 and showed a positive correlation with HOMA -IR. In conclusion, our findings suggested that systemic inflammation has an important role in the pathogenesis of pre diabetic condition. There is a progressive raises value of tumor necrosis factor alpha in pre diabetic and diabetic patients. Therefore, inflammation reflects the severity of the disease and signifies the presence of ongoing disease process.

One-hour post-load hyperglycemia combined with HbA1c identifies individuals with augmented duodenal levels of sodium/glucose co-transporter 1

AimsIndividuals with HbA1c-defined prediabetes (HbA1c 5.7–6.4%) and 1-hour post-load plasma glucose (1hPG) ≥ 155 mg/dl have an increased risk to develop type 2 diabetes (T2DM). T2DM is associated with a higher intestinal expression of sodium/glucose co-transporter 1 (SGLT-1) and glucose transporter 2 (GLUT-2). It is currently unsettled whether HbA1c-defined dysglycemic conditions combined to 1hPG ≥ 155 mg/dl are associated with changes in SGLT-1 and GLUT-2 duodenal abundance. MethodsSGLT-1 and GLUT-2 protein levels were assessed by western blot on duodenal mucosa biopsies of 57 individuals underwent an upper gastrointestinal endoscopy. ResultsCompared with the normal group (HbA1c < 5.7%), individuals with HbA1c-defined pre-diabetes and diabetes exhibit no significant change in duodenal SGLT-1 abundance. Conversely, duodenal GLUT-2 levels were progressively increased in subjects with prediabetes and diabetes. Stratifying participants according to HbA1c and 1hPG we found that amongst subjects with HbA1c-defined normal or prediabetes condition those having 1hPG ≥ 155 mg/dl displayed higher duodenal levels of SGLT-1 as compared to their counterparts with 1hPG < 155 mg/dl; in contrast to GLUT-2 levels, which were similar between normal and with prediabetes subjects, regardless of 1hPG value. ConclusionA value of 1hPG ≥ 155 mg/dl may identify a subset of individuals within HbA1c-defined glycemic categories having a higher duodenal abundance of SGLT-1.

Sex-Specific Effects of Vitamin D Status on the Metabolic Profile in Prediabetic Subjects.

Introduction We aim to investigate the effect of vitamin D on metabolic parameters in a population with prediabetes and to detect possible sex differences. Methods In 621 patients with diagnosed prediabetes, glucose, lipid, and anthropometric parameters were measured. Furthermore, the interaction of 25-OH-vitamin D (25-hydroxyvitamin D) with metabolic and glucose metabolism parameters was analysed in the total prediabetic population, as well as after stratification by sex (female vs. male prediabetic subgroup), by logistic regression. Results 25-OH-vitamin D was negatively related to cholesterol, BMI, fatty liver index, insulin, and HOMA-IR. Especially in the male prediabetic cohort, 25-OH-vitamin D levels negatively correlated with total cholesterol levels (r = −0.17, p=0.001), with triglycerides (r = −0.17, p=0.001), and with HbA1c levels (r = −0.14, p=0.010). Only in the female cohort with prediabetes, we found a negative correlation of 25-OH-vitamin D levels with systolic (r = −0.18, p=0.005) and diastolic blood pressures (r = −0.23, p < 0.001). Conclusion In this study, in females with prediabetes, 25-OH-vitamin D was notably related to a more favourable metabolic profile, including lower total cholesterol and higher HDL cholesterol levels. On the contrary, in men with prediabetes, there was a stronger association between 25-OH-vitamin D and cholesterol-HDL quotient, as well as fatty liver index was observed in the male prediabetic subgroup. Therefore, sex differences should be considered in future studies on vitamin D and glucose tolerance status.

Evaluation of Anthropometric Indices and Biochemical Markers in Iranian Prediabetics in Hoveyzeh Located in Southwest Iran: A Cross-sectional Study

Background: The number of prediabetic individuals is rising rapidly in Iran and other parts of the world. This complication seriously affects life quality and public health. Objectives: This study aimed to evaluate the anthropometric indices and biochemical measures among the prediabetic population. Methods: This cross-sectional study was conducted on prediabetic subjects in the Hoveyzeh population, Iran, during 2018 - 2019. A sample of 240 prediabetic individuals within the age range of 30 - 75 years enrolled in this study. The demographic characteristics, anthropometric measurements, and participants’ clinical parameters were checked out in this study. Moreover, this study investigated important demographic variables associated with anthropometric and clinical parameters. Results: The results showed that the mean values of fasting plasma glucose, triglyceride, and total cholesterol were 113.13 ± 6.8, 193.64 ± 115.44, and 193.64 ± 40.67 mg/dl, respectively. The mean values of systolic blood pressure and diastolic blood pressure (DBP) were 114.75 ± 15.25 and 73.25 ± 8.81 mmHg, respectively. The results showed no statistically significant difference between clinical and demographic variables except between DBP and marital status (P &lt; 0.05). The prevalence of prediabetes in Hoveyzeh was closely associated with some demographic, anthropometric, and clinical variables. This study documented significant associations between height, hip circumference, and body mass index with both genders (P &lt; 0.05). Furthermore, there was no statistical relationship between other demographic and anthropometric variables (P &gt; 0.05). Conclusions: Based on the findings, abdominal obesity indicators may be related to prediabetes. Therefore, preventive strategies and suitable educational programs should be based on influential factors.

Beta Cell Function and Insulin Resistance in Nondiabetic, Prediabetic and Diabetic in a Subset of Obese Pakistani Population

Objective: To compare insulin resistance and beta-cell function in nondiabetic, prediabetic, and diabetic subjects in a subset of obese Pakistani population.&#x0D; Materials and Methods: Two hundred and ten obese subjects underwent anthropometric measurements. After overnight fasting for 8 hours, 6 cc blood was drawn for fasting blood glucose level, fasting insulin level. Blood glucose samples were taken after drinking 75 gm glucose in 260 ml water. HOMA IR and HOMA BETA% were calculated by the formula. Subjects were divided into obese nondiabetic, obese prediabetic and obese diabetic according to WHO criteria.&#x0D; Results: Out of 210 obese subjects, 53 (25.2%) were males and 157 (74.8%) were females. The mean BMI was 32.39±5.21. Mean abdominal circumference was 102.78±10.16. There were 101(48%) obese nondiabetic, 51(24%) were found to be obese prediabetic, 58(28%) were found to be obese diabetic. Mean insulin resistance in obese nondiabetic subjects was 2.8 ±3.7, in prediabetic 8.5± 12.3, in diabetic was 17.7±24.6. Mean HOMA beta was 245.3±267.4 in obese nondiabetic subjects, 290.5±298.4 in prediabetic, and 16.6±57 in diabetic.&#x0D; Conclusion: There was a significantly increased incidence of prediabetes and diabetes in obese subjects. Prediabetic and diabetic subjects were found to have marked insulin resistance. Beta-cell function was markedly reduced in diabetic subjects having a family history of diabetes, emphasizing the genetic predisposition to develop beta-cell exhaustion.

Serum branched-chain amino acids modifies the associations between air pollutants and insulin resistance

Growing evidence supports that air pollution exposure has become a risk factor of type II diabetes mellitus through the induction of insulin resistance (IR), but the presented findings did not provide a consistent relationship between air pollution exposure and IR in the temporal scale and the magnitude. Reported associated with IR and air pollution exposure, branched-chain amino acids (BCAAs) in blood might modify the association between air pollution exposure and IR. We took advantage of an existing panel study on elderly people who were healthy or with pre-diabetes. Amino acids were analyzed from the serum samples using a UPLC-QQQ-MS, and the homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated to represent the levels of IR in each visit. Exposures to PM2.5, NO2, SO2, CO, O3, and black carbon (BC) were estimated using data from a monitoring station. Linear mixed-effects models were applied to estimate the associations between the air pollution and HOMA-IR, as well as the modifying effects of BCAAs. We found significantly higher concentrations of BCAAs in the pre-diabetic subjects than healthy ones. The concentrations of BCAAs were all significantly associated with HOMA-IR. For subjects with high-level BCAAs, HOMA-IR was positively associated with an IQR increase in PM2.5, NO2, BC, and CO at lag day 2 and in PM2.5, SO2, NO2, BC, and CO at lag day 7. While for subjects with low-level BCAAs, there was no significant association observed at any lag day except for CO at lag day 5. The study provided evidence that circulating BCAAs may modify the relationship between air pollution exposure and the level of insulin resistance in humans.

Prognostic value of subclinical myocardial necrosis using high-sensitivity cardiac troponin T in patients with prediabetes

BackgroundRisk stratification of patients with prediabetes is an unmet clinical need. Here, we examine the utility of subclinical myocardial necrosis assessed by high-sensitivity cardiac troponin T (hs-cTnT) in predicting health outcomes in stable subjects with prediabetes.Methodshs-cTnT was analyzed by a high-sensitivity assay (Roche 5th generation) in 2631 stable subjects with prediabetes (HbA1c 5.7–6.4% or fasting glucose 100–125 mg/dL without previous diagnosis of diabetes or glucose-lowering therapy) who underwent elective coronary angiography for cardiac evaluation, and followed for major adverse cardiac events (MACE; death, myocardial infarction, stroke) over 3 years and all-cause mortality over 5 years.ResultsIn our study cohort, hs-cTnT was highly prevalent with a median level of 13 ng/L (interquartile range 8.2–21.6 ng/L). Hs-cTnT was independently associated with incident MACE at 3 years (Q4 vs. Q1 adjusted hazard ratio (HR) 2.42 [95% CI 1.69–3.46], P < 0.001) and 5-year mortality (adjusted HR 3.8 [95% CI 2.55–5.67], P < 0.001). This association remained significant in all subsets after adjustment for traditional risk factors and multiple factors known to increase hs-cTnT levels. Moreover, hs-cTnT independently predicted event risk in primary prevention subjects (n = 557, HR 5.46 [95% CI 1.50–19.89), p < 0.01) for MACE; HR 9.53 [95% CI 2.08–43.73] for all-cause mortality) and secondary prevention subjects (n = 2074, HR 1.86 [95% CI 1.31–2.66], P < 0.001 for MACE; and 2.7 [95% CI 1.79–4.08), P < 0.001 for all-cause mortality).ConclusionsIn stable prediabetic subjects, the presence of subclinical myocardial necrosis as detected by hs-cTnT portends heightened long-term adverse cardiovascular event risk. Hs-cTnT levels may help to stratify risk and improve clinical decision making in patients with prediabetes.Trial registration ClinicalTrials.gov Identifier: NCT00590200.

High glomerular filtration rate is associated with impaired arterial stiffness and subendocardial viability ratio in prediabetic subjects

Background and aimsHigh glomerular filtration rate (HGFR) is associated with cardiovascular damage in the setting of various conditions such as obesity and diabetes. Prediabetes was also associated with increased GFR, however, the association between prediabetes, HGFR and cardiovascular damage has not been investigated. In this study, we investigated the association between HGFR and early markers of cardiovascular disease in subjects with prediabetes. Methods and resultsAugmentation pressure (Aug), augmentation index (AIx), subendocardial viability ratio (SEVR), pulse wave velocity (PWV), intima-media thickness (IMT) and estimated GFR (eGFR) were evaluated in 230 subjects with prediabetes. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration formula. HGFR was defined as an eGFR above the 75th percentile.Prediabetic subjects were divided into two groups according to presence/absence of HGFR: 61 subjects with HGFR and 169 subjects without HGFR. Subjects with HGFR showed higher Aug, AIx and lower SEVR compared with prediabetic subjects with lower eGFR (14.1 ± 7.2 vs 10.8 ± 6.2, 32.9 ± 12.7 vs 27.6 ± 11.7, 153.5 ± 27.8 vs 162 ± 30.2, p < 0.05). No differences were found in PWV and IMT values between the two groups. Then, we performed multiple regression analysis to test the relationship between Aug, SEVR and several cardiovascular risk factors. In multiple regression analysis Aug was associated with age, systolic blood pressure (BP), HOMA-IR and eGFR; the major determinants of SEVR were systolic BP, HOMA-IR and eGFR. ConclusionSubjects with prediabetes and HGFR exhibited an increased Aug, AIx and a reduced SEVR. These alterations are associated with eGFR, insulin resistance and systolic BP.

Differences in Abdominal Body Composition According to Glycemic Status: An Inverse Probability Treatment Weighting Analysis.

BackgroundSeveral studies have reported that abdominal fat and muscle changes occur in diabetic patients. However, there are few studies about such changes among prediabetic patients. In this study, we evaluated the differences in abdominal fat and muscles based on abdominopelvic computed tomography in prediabetic and diabetic subjects compared to normal subjects.MethodsWe performed a cross-sectional study using health examination data from March 2014 to June 2019 at Ulsan University Hospital and classified subjects into normal, prediabetic, and diabetic groups. We analyzed the body mass index corrected area of intra-abdominal components among the three groups using inverse probability treatment weighting (IPTW) analysis.ResultsOverall, 8,030 subjects were enrolled; 5,137 (64.0%), 2,364 (29.4%), and 529 (6.6%) subjects were included in the normal, prediabetic, and diabetic groups, respectively. After IPTW adjustment of baseline characteristics, there were significant differences in log visceral adipose tissue index (VATI; 1.22±0.64 cm2/[kg/m2] vs. 1.30±0.63 cm2/[kg/m2] vs. 1.47±0.64 cm2/[kg/m2], P<0.001) and low-attenuation muscle index (LAMI; 1.02±0.36 cm2/[kg/m2] vs. 1.03±0.36 cm2/[kg/m2] vs. 1.09±0.36 cm2/[kg/m2], P<0.001) among the normal, prediabetic, and diabetic groups. Prediabetic subjects had higher log VATI (estimated coefficient=0.082, P<0.001), and diabetic subjects had higher log VATI (estimated coefficient=0.248, P<0.001) and LAMI (estimated coefficient=0.078, P<0.001) compared to normal subjects.ConclusionConsidering that VATI and LAMI represented visceral fat and lipid-rich skeletal muscle volumes, respectively, visceral obesity was identified in both prediabetic and diabetic subjects compared to normal subjects in this study. However, intra-muscular fat infiltration was observed in diabetic subjects only.

Renal Function, Albumin-Creatinine Ratio and Pulse Wave Velocity Predict Silent Coronary Artery Disease and Renal Outcome in Type 2 Diabetic and Prediabetic Subjects.

Silent coronary heart disease is frequently undetected in type 2 diabetes mellitus (DM2) and pre-diabetes determined by glucose intolerance (GI). Pulse wave velocity (PWV) and albumin-creatinine ratio (ACR) have been considered markers of cardiovascular mortality, coronary heart disease and chronic renal failure. To evaluate the incidence of coronary artery disease (CAD) and the relationship between urinary albumin-creatinine ratio, glomerular filtration rate (GFR) and PWV in type 2 DM with silent CAD. We analyzed 92 individuals (44 male), 49 (60±7y) type 2 DM non-insulin dependents and 43 prediabetics (43±4y), with Grade I-II hypertension and no symptoms of CAD. All type 2 DM patients were under antidiabetic treatment with A1C hemoglobin between 5.5 and 6.5%. Every patient underwent a myocardial perfusion SPECT scan. In those subjects with ischemic patterns, coronary angiography was performed. In addition, PWV, glomerular filtration rate, and ACR were evaluated. mean±SEM, and ANOVA among groups. 48.59% of DM2 and 25.58% of GI patients had silent coronary artery had silent coronary artery disease and higher ACR, PWV and reduced GFR. Higher ACR and PWV and reduced GFR. DM2 and GI showed a negative relationship between GFR and ACR. Moreover, this relation was also observed in different levels of GFR (>60 ml/min and <60ml.min (p<0.05) in patients with CAD, suggesting a cardio-renal interaction in DM2. Higher PWV, lower GFR and ACR predict the incidence of CAD in DM2. Dysglycemic individuals also represent a group of higher risk for coronary artery disease with similar predictors as in DM2. Diabetic and prediabetics still develop renal microalbuminuria. Thus, PWV seems to represent a reliable marker of renal impairment and coronary artery disease.

Cover Image

The cover image is based on the Article Type The effect of curcumin and zinc co-supplementation on glycemic parameters in overweight or obese prediabetic subjects: A phase 2 randomized, placebo-controlled trial with a multi-arm, parallel-group design by Majid Karandish et al., https://doi.org/10.1002/ptr.7136.