Prediabetes Group Research Articles

Features of COVID-19 course in patients with obesity and dysglycemia

Aim. To study the features of coronavirus disease 2019 (COVID-19) in patients with different severity of carbohydrate metabolism disorders (CMDs), taking into account the possible role of obesity in the acceleration of clinical and laboratory disorders.Material and methods. There were 137 consecutive patients admitted to the infectious disease hospital for COVID-19patients. Three 3 groups were formed: group 1 — 42 patients with concomitant type 2 diabetes (T2D); group 2 — 13 patients with concomitant prediabetes; group 3 — 82 patients without concomitant CMDs.Results. Patients with T2D tended to have a more severe disease course according to the SMRT-CO algorithm (p=0,089), which was associated with the longest hospital stay (p=0,038), the most pronounced (p=0,011) and prolonged (p=0,0001) decrease in oxygen saturation, the maximum percentage of lung injury at the beginning (p=0,094) and at the end (p=0,007) of hospitalization, the greater need for intensive care unit (p=0,050), as well as the highest increase in C-reactive protein and fibrinogen (hypercoagulability and systemic inflammation were noted in all groups). Patients with prediabetes in terms of COVID-19 severity occupied an intermediate position between those with T2D and without CMDs; at the same time, they most often needed the prescription of biological preparations (p=0,001). In the first and second groups, there were larger, compared with the control, proportions of obese people (61,9%, 53,8% and 30,5%, respectively, p=0,003). Prediabetes group had a strong correlation between the severity of viral pneumonitis according to SMRT-CO and the presence of obesity (R=0,69, p=0,009).Conclusion. In patients with impaired carbohydrate metabolism of any severity, COVID-19 is more severe. At the same time, persons with overt T2D are prone to the most severe COVID-19 course, while patients with prediabetes in terms of disease severity occupy an intermediate position between them and those without CMDs. Obesity is a strong risk factor for severe COVID-19 among patients with initial CMDs (prediabetes), which is partly mediated by prior liver dysfunction associated with the metabolic syndrome. The increase in proinflammatory changes and hypercoagulability is associated with COVID-19 severity in patients with and without CMDs. These disorders had the greatest severity and persistence in patients with T2D.

Evaluation of left atrial volume and functions by 3D echocardiography in patients with prediabetes and investigation of its correlation with NT-pro ANP levels

Aim: An increased burden of cardiovascular disease is observed in prediabetes compared to normoglycemic. In this study, we aimed to evaluate left atrium (LA) volume indices and mechanical functions in prediabetes patients by real-time three-dimensional echocardiography (3DE) and examine the relationship of these parameters with N-terminal pro-atrial natriuretic peptide (NT-pro-ANP) levels.Methods: 41 patients diagnosed with prediabetes by the oral glucose tolerance test in the endocrinology outpatient clinic and 43 healthy controls were included in this study. We evaluated the volume indices and mechanical functions of the LA using 3DE. Plasma NT-proANP was evaluated by the enzyme-linked immunosorbent assay method.Results: Median NT-pro-ANP level was higher in the prediabetes group than the control group (1.5 vs 0.7 nmol/L, p

Serum nesfatin-1 is a biomarker of pre-diabetes and interplays with cardiovascular risk factors

Background and objectivesNesfatin-1 as a potent anorexigenic peptide is secreted by pancreatic β cells. Conflicting data are available about its level among diabetic patients. Our study aimed to assess nesfatin-1 levels in newly diagnosed drug-naïve diabetic and pre-diabetic patients and its association with cardio-metabolic risk and insulin resistance (IR). This case-control study included drug-naive patients with DMT2 (group 1, n = 30) and pre-diabetes (group 2, n = 30) in addition to healthy subjects (group 3, n = 28). Anthropometric and routine biochemical assessments were performed. Serum nesfatin-1and plasma insulin levels were assessed by ELISA methods. Homeostatic model for assessment of IR (HOMA-IR) was calculated.ResultsSerum nesfatin-1 was significantly lower in diabetic and pre-diabetic compared to healthy subjects (3.89 ± 1.1 ng/dl and 7.47 ± 1.22 ng/dl versus 15.39 ± 3.53 respectively, p < 0.001). Also diabetic patients had statistically significant lower nesfatin-1 levels than pre-diabetic patients (p < 0.001) Roc curve analysis identified cut-off values of ≤ 9 ng/dl and ≤ 5.5 ng/dl with an AUC of 0.94 and 0.97, sensitivity of 96.7 and 100%, and specificity of 93.3% and 96.7% for diagnosis of pre-diabetes and diabetes respectively. Using bivariate analysis, nesfatin-1 was negatively correlated with glycemic parameters (fasting and 2 h postprandial blood sugar, HBA1c), IR parameters (fasting insulin and HOMA-IR) and atherogenic lipid profile (triglyceride, cholesterol, and LDL-c); and positively correlated to HDL-c in both diabetic and pre-diabetic but not in healthy.ConclusionNesfatin-1 is an excellent predictor for pre-diabetes and DMT2. It is associated with favorable glucose and lipid metabolism probably via insulin signaling pathway.

Cytokine signature for predicting new-onset prediabetes after acute pancreatitis: A prospective longitudinal cohort study.

Acute inflammation of the pancreas often leads to metabolic sequelae, the most common of which is new-onset prediabetes (and, ultimately, diabetes). However, there is a lack of studies on predictors of this sequela. The aim was to investigate whether cytokines/chemokines measured at baseline are predictive of new-onset prediabetes after acute pancreatitis (NOPAP). This was a prospective longitudinal cohort study (as part of the LACERTA project) that included 68 individuals with non-necrotising acute pancreatitis who had no diabetes mellitus. Of them, 17 individuals had prediabetes at baseline and during follow-up, 37 individuals had normoglycaemia at baseline and during follow-up, and 14 individuals had normoglycaemia at baseline and developed NOPAP during follow-up. A commercially available human cytokine/chemokine multiplex kit was used to measure a total of 28 analytes at baseline. Multinomial regression analyses were conducted to investigate the associations between the cytokines/chemokines and the three study groups. Interleukin-1β and interferon γ significantly predicted progression to NOPAP with an odds ratio (95% confidence interval) of 1.097 (1.002, 1.201) and 1.094 (1.003, 1.192), respectively (after accounting for age, sex, body mass index, and aetiology of acute pancreatitis). None of the studied cytokines/chemokines showed statistically significant associations with the antecedent prediabetes group (after accounting for the above covariates). Elevated levels of interleukin-1β and interferon γ in acute pancreatitis individuals with normoglycaemia at baseline may predict progression to NOPAP during follow-up.

Comparative study of serum calcium, serum phosphorus and alkaline phosphatase between prediabetes and type-2 diabetes mellitus

Background: Diabetes mellitus, a group of metabolic disorder with multiple etiologies is characterized by chronic hyperglycaemia, induced by deficiency of insulin production and insulin action. Prediabetes is a type of hyperglycemia in which glycemic indices are higher than normal but lower than the diabetes threshold. Objective: This study aims to assess the impact of bone markers (serum calcium, phosphorus and alkaline phosphatase) on prediabetic and type 2 diabetes mellitus patients. Material and Methods: This study was carried out during 2021 from January to December, in Department of Biochemistry, Teerthanker Mahaveer Hospital, and Moradabad. Comparative levels of serum calcium, serum phosphorus and alkaline phosphatase between 65 Prediabetic and 65 Type2 diabetes mellitus patients were measured using automated method. Results: Serum ALP and serum phosphorus were significantly higher in the diabetic patients than that in the pre diabetic group (p

Circulating C-Terminal Agrin Fragment

Background:Undetected onset of sarcopenia among individuals with chronic diseases especially Type 2 Diabetes Mellitus (T2D) makes it important to be evaluated. The feasibility of diagnosing sarcopenia in a clinical setup might be a difficult task. Circulating markers including C-terminal agrin fragment (CAF) are emerging as an alternative. Hence, the objectives of the study were to compare circulating CAF levels between T2D, prediabetes (PD) and healthy controls and to study its association with sarcopenic index, muscle mass, strength and quality.Methods:Ninety-nine participants (n = 42, T2D; n = 33, PD; n = 24, healthy controls) aged 18 to 60 yrs were recruited. HOMA (homeostatic model assessment) indices were derived using plasma glucose and insulin. All participants underwent lipid profiling, muscle strength including quality (isokinetic dynamometer), body composition (Dual energy X-ray Absorptiometry (DXA)) and sarcopenic index (appendicular skeletal muscle mass/body weight) assessment. Serum samples were used to estimate CAF levelsusing enzyme-linked immunosorbent assay (ELISA).Results:Median CAF level was significantly higher among T2D group compared to PD and control groups (P < 0.0001). Circulating CAF levels correlated positively with age and glycated haemoglobin (HbA1c) (both, P < 0.001) and negatively with HOMA-B and muscle quality (both, P < 0.001), and sarcopenic index (P = 0.07). Multivariable analysis demonstrated that the odds of being in the highest tertile category was 7.67, 95% C.I. (2.10, 29.3) among T2D.Conclusion:Circulating CAF levels were significantly higher among T2D compared to PD and control study groups along with reduced skeletal muscle quality. This suggests that the circulating CAF level has the potential to be considered as a clinical marker to evaluate sarcopenia among T2D.

Association between gut microbiota and prediabetes in people living with HIV.

The prevalence of prediabetes is rapidly increasing in general population and in people living with HIV (PLWH). Gut microbiota play an important role in human health, and dysbiosis is associated with metabolic disorders and HIV infection. Here, we aimed to evaluate the association between gut microbiota and prediabetes in PLWH. A cross-sectional study enrolled 40 PLWH who were receiving antiretroviral therapy and had an undetectable plasma viral load. Twenty participants had prediabetes, and 20 were normoglycemic. Fecal samples were collected from all participants. The gut microbiome profiles were analyzed using 16S rRNA sequencing. Alpha-diversity was significantly lower in PLWH with prediabetes than in those with normoglycemia (p<0.05). A significant difference in beta-diversity was observed between PLWH with prediabetes and PLWH with normoglycemia (p<0.05). Relative abundances of two genera in Firmicutes (Streptococcus and Anaerostignum) were significantly higher in the prediabetes group. In contrast, relative abundances of 13 genera (e.g., Akkermansia spp., Christensenellaceae R7 group) were significantly higher in the normoglycemic group. In conclusion, the diversity of gut microbiota composition decreased in PLWH with prediabetes. The abundances of 15 bacterial taxa in the genus level differed between PLWH with prediabetes and those with normoglycemia. Further studies on the effect of these taxa on glucose metabolism are warranted.

Evaluation of Renal Function in COVID-19 Patients by Using Urinalysis Following the Administration of Vancomycin.

The aim of this study was to evaluate renal function by urinalysis in COVID-19 patients following the administration of vancomycin. A retrospective observational study was performed between October 2020 and January 2021, during which time patients were hospitalized in the Prince Mohammed Bin Abdulaziz Hospital in Riyadh, Saudi Arabia. The patients were free of kidney disease. Urinalysis was performed by an automated laboratory system, and the collected results were based upon age, gender, diabetic status, whether the patients had received vancomycin, the mortality rate, and the urinalysis panel including coinfection by bacteria and yeast. A total of 227 patients were included in this study, 147 (64.75%) of whom were male and 80 (35.25%) of whom were female; 54.63% were diabetic, 11.89% were prediabetic, and 33.48% were non-diabetic patients. Proteinuria, hematuria, glycosuria, coinfection, and ketonuria were detected among all participants within the study group, specifically among diabetic patients. The mortality rate was 16.2% among the study group; 6.6% had re-ceived vancomycin, and 9.6% had not received vancomycin. No significant correlation was found between nephrotoxicity and abnormalities in the urine and the mortality rate among members of our study group. Proteinuria, hematuria, glycosuria, ketonuria, and coinfection were common among members of our study group, especially in the diabetic group. Urinalysis abnormalities were less frequent in the vancomycin group than in the others, except the prediabetic group. No correlation between mortality and vancomycin was identified.

Correlation of CA 19-9 with HbA1c in prediabetic and diabetic groups

Introduction and Aim: Carbohydrate antigen19-9 (CA 19-9) is a marker of pancreatic cancer. In diabetics, pancreatic beta cell dysfunction can lead to elevated serum CA19-9 level. This study was designed for estimation of CA19-9 in diabetes and its correlation with glucose levels and glycosylated hemoglobin. Materials and Methods: The includes diabetic, pre diabetic with no history of malignancies and healthy normal subjects (n=50 each). Ca19-9 was estimated using ELISA, HbA1c by D10-Biorad variant turbo and the Lipid profile in Roche COBAs 6000 auto analyzer. Statistical analysis was done by Statistical Package for Social Sciences software version17 (SPSS 17). P &lt;0.05 was considered significant. Results: Serum CA19-9 level was high in diabetics compared to normal, (p=0.38) however it was decreased in pre diabetic group (P=0.06). There was significant difference in comparison of CA19-9 levels between pre diabetic and diabetics(p=0.001). A significant increase in triglycerides was observed both in diabetics (p&lt;0.01) and pre-diabetics(p=0.04). There was a significant positive correlation of CA19-9 with TC/HDL (p=0.022) and non-HDL(p) in control group. Conclusion: CA19-9 levels can be influenced by glycemic status, hence assessment of pancreatic cancer in diabetic patients must be interpreted carefully in consideration with CA19-9 levels. CA19-9 level was decreased in prediabetics when compared to normal and diabetics. This is a novel finding, the cause for which must ascertained, and this will open further avenues for research.

Beta cell function, incretin hormones, and incretin effect in obese children and adolescents with prediabetes.

Defects of incretin hormones and incretin effect may be underlying mechanisms of abnormal glucose metabolism in youth. To assess incretin hormone dynamics during an oral glucose tolerance test (OGTT) and incretin effect in obese children with prediabetes in comparison with those with normal glucose tolerance (NGT). Overweight and obese children were enrolled and classified according to OGTT results as NGT and prediabetes. Insulin sensitivity, insulin secretion, incretin hormone concentrations during OGTT; and incretin effect derived from OGTT and intravenous glucose tolerance test were determined and compared between NGT and prediabetes groups. Sixty-three patients (43 NGT and 20 prediabetes) were enrolled. Their median (interquartile range) age was 12.5(11.1, 13.8)years. Peak glucagon-like peptide-1 (GLP-1) was demonstrated at 30min during OGTT and was higher in the prediabetes group (49.2 [35.6, 63.6] versus 36.5 [27.6, 44.2] pmol/L, p=0.009). However, incremental areas under the curves (iAUCs) of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) were not different between the two groups. There was no difference in incretin effect between NGT and prediabetes (NGT: 66.5% [60.2%, 77.5%] vs. prediabetes: 70.0% [61.5%, 75.0%], p=0.645). Incretin effect had positive correlations with iAUCs of both GLP-1 and GIP (GLP-1: r=0.40, p=0.004 and GIP: r=0.37, p=0.009). Comparing between obese children with prediabetes and NGT, there were no differences in overall incretin hormone changes during OGTT and incretin effect. Incretin effect was positively correlated with iAUCs of GLP-1 and GIP.

Reduced Lung Function and Progression to Prediabetes: A Prospective Study

Objective: Prediabetes is a state that people have blood glucose levels higher than normal but still not in diabetes range. There is a close relationship between impaired lung function and diabetes mellitus (DM). Reduced lung function can be present before the clinical evidence of diabetes or insulin resistance. Materials and Methods: The total number of subjects in this longitudinal study was 503 and compared with apparently healthy Kashmiri adults. All the subjects, at the time of their first visit, underwent Fasting Plasma Glucose (FPG) estimation, 2- hour oral glucose tolerance test (OGTT) and spirometry (FVC, FEV1 &amp; FEV1/FVC). Those subjects who had normal glucose tolerance (NGT) were retested for glycemic status and spirometric values after a follow-up period of 2-18 (mean=10) months. Results: Out of total 503 subjects on follow up 483 (96%) had NGT and 20 (4%) had prediabetes. Percent predicted forced vital capacity (FVC) and % predicted forced expiratory volume in 1st second (FEV1) were significantly lower (P-value&lt; 0.001) while as % predicted FEV1/FVC was significantly higher (P-value&lt; 0.001) in prediabetes as compared to NGT group. Conclusion: Results of our study point out a predominantly restrictive pattern of lung dysfunction in the prediabetes group as compared to the NGT group.

Knowledge, Attitudes, and Screening for Obstructive Sleep Apnea and Diabetes Mellitus among War Veterans Seeking Treatment of Posttraumatic Stress Disorder.

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders. However, we should not neglect the somatic aspects of PTSD. Associations with cardiovascular diseases (CVD) are particularly concerning because PTSD was associated with an even 53% higher risk for CVD. This study aimed to analyze the prevalence of several CVD risk factors, especially diabetes mellitus among PTSD patients divided into three groups according to obstructive sleep apnea (OSA) risk stratification (low, intermediate, and high). This cross-sectional study included one hundred male PTSD veterans. The mean age was 53 (40–67) years. The estimated OSA risk was 95% for the whole cohort, and 53% were in the high-risk group. Median HbA1c was 5.6 (4.6–10)%. The hemoglobin A1c (HbA1c) levels showed that 34 patients were in the prediabetes group, and 20 of them fulfilled the criteria for diabetes. However, only 13 of them were aware of their previous diagnosis of diabetes mellitus. In testing knowledge about diabetes, 62% and only 23% of patients knew the correct definition of HbA1c and level of fasting plasma glucose, respectively. Diabetic patients had insufficient knowledge about diabetic complications and treatment. A higher level of PTSD symptoms in veterans was associated with a higher prevalence of OSA. The results strongly support further research and education into early detection of CVD risk factors associated with PTSD.

Outcomes between prediabetes and type 2 diabetes mellitus in older adults with acute myocardial infarction in the era of newer-generation drug-eluting stents: a retrospective observational study

BackgroundThe comparative clinical outcomes between prediabetes and type 2 diabetes mellitus (T2DM) in older adults with AMI in the era of newer-generation drug-eluting stents (DES) are limited. We investigated the 2-year clinical outcomes of these patients.MethodsA total of 5492 AMI patients aged ≥65 years were classified into three groups according to their glycemic status: normoglycemia (group A: 1193), prediabetes (group B: 1696), and T2DM (group C: 2603). The primary outcome was the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization. The secondary outcome was stent thrombosis (ST).ResultsThe primary and secondary outcomes cumulative incidences were similar between the prediabetes and T2DM groups. In both the prediabetes and T2DM groups, the cumulative incidences of MACE (adjusted hazard ratio [aHR]: 1.373; p = 0.020 and aHR: 1.479; p = 0.002, respectively) and all-cause death or MI (aHR: 1.436; p = 0.022 and aHR: 1.647; p = 0.001, respectively) were significantly higher than those in the normoglycemia group. Additionally, the cumulative incidence of all-cause death in the T2DM group was significantly higher than that in the normoglycemia group (aHR, 1.666; p = 0.003).ConclusionsIn this retrospective study, despite the 2-year clinical outcomes of the patients with prediabetes and T2DM in the older adults were worse than those in the normoglycemia group; they were similar between the prediabetes and T2DM groups. Hence, comparable treatment strategies should be strengthened between prediabetes and T2DM in older adults with AMI.Trial registrationRetrospectively registered.

A randomized, double-blind clinical trial of a herbal formulation (GlycaCare-II) for the management of type 2 diabetes in comparison with metformin

BackgroundType 2 diabetes mellitus (T2DM) is a major public health concern with growing prevalence with multiple debilitating complications. GlycaCare-II is a proprietary herbal formulation supplement for T2DM containing extracts of Cinnamomum cassia, Momordica charantia, Pterocarpus marsupium, Gymnema sylvestre, Salacia reticulata, Eugenia jambolana, and a bioavailability enhancer piperine from Piper nigrum.ObjectiveThe antihyperglycemic potential of GlycaCare-II was compared against metformin in a double-blind study.DesignIt was a randomized, two-arm design on prediabetic (N = 29; 12 in metformin and 17 in GlycaCare-II arm, respectively) and newly diagnosed diabetic (N = 40; 16 in metformin and 24 in GlycaCare-II) patients for 120 days.Outcome measuresChanges in diabetic panel glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), and postprandial blood sugar (PBS) were the primary endpoints. Lipid profile, liver profile, thyroid-stimulating hormone, bilirubin and creatinine were the secondary endpoints.ResultTwice a day treatment for 120 days with GlycaCare-II led to a statistically significant change in HbA1c (p < 0.001), FBS (p < 0.001), PBS (p < 0.001) on both prediabetic and newly diagnosed diabetic patients. GlycaCare-II showed a similar potential as metformin in the treatment of T2DM. In the prediabetic group, both GlycaCare-II and metformin were comparable for all the hyperglycemic index parameters. In the case of newly diagnosed diabetic patients, GlycaCare-II showed a significantly better reduction for PBS (p = 0.026) as compared to metformin, while all other parameters in the diabetic panel were comparable. No adverse events were reported throughout the trial period.ConclusionThese results suggest that GlycaCare-II is effective in managing T2DM in both newly diagnosed diabetic and prediabetic patients.

The impact of prediabetes in the first trimester of pregnancy on the incidence of gestational diabetes

Introduction: Prediabetes (PD) outside of pregnancy is a condition reflecting a significant loss of glucose tolerance, characterized in the laboratory by fasting glucose between 100 and 125 mg/dL or 2 hour glucose in the 75 g Oral Glucose Tolerance Test (OGTT) between 140 and 199 mg/dL or by HbA1c levels between 5.7%-6.4% and is associated with an increased risk of developing type 2 diabetes. The development of gestational diabetes mellitus (GDM) during pregnancy, characterized by a fasting blood glucose between 92 and 125 mg/dL or an impaired OGTT value of 75 g between 24th and 28th weeks, is another condition that increases the risk of perinatal complications such as preeclampsia, cesarean section rate, macrosomia, and also the development of type 2 diabetes after delivery. Determining the prevalence of women diagnosed with prediabetes at the beginning of prenatal care and its association with the diagnosis of GDM is therefore of great importance for clinical, gynecological and obstetric care. Objective: the aim of the study is to determine the prevalence and association of prediabetes in the first trimester of pregnancy with the development of gestational diabetes&#x0D; Methodology: It was carried out in the Clinical Hospital of Botucatu Medical School. Retrospective cohort study involving eligible pregnant women who underwent fasting glucose test (FG) and glycated hemoglobin (HbA1c) test up to the 14 th week of gestation without previous diagnosis of diabetes mellitus, and who underwent 75 g oral glucose tolerance test (between the 24th and 28th week). We excluded cases in which FG was between 92 mg/dL and 125 mg/dL, which were considered GDM, and cases with FG ≥ 126 mg/dL and/or HbA1c ≥ 6.5 % (overt diabetes). One thousand electronic medical records from between 2013 and 2021 were reviewed and a database was created. The partial results were presented as percentage and 95 Confidence Interval (95% CI). The association between HbA1c and GDM was presented as relative risk and 95% CI. Results: Among pregnant women with normal fasting glucose levels and HbA1c &lt;5.7%, the incidence of GDM, diagnosed by OGTT, was 8.5% (6.4-11.3), while in the group with PD was 14.3% (5.8%-29.8%). The relative risk (RR) for developing GDM among the PD group was 1.7 (0.7-3.9). Discussion and conclusion: The association between prediabetes and gestational diabetes was not confirmed. However, these results are preliminary, and we need to reach the sample size calculated before starting the study to better understand these results. Furthermore, nonpregnant women with prediabetes are monitored and eventually treated, therefore, further studies are needed to evaluate the benefit of treating these pregnant women as recommended for the general population

Influence of Prediabetes on Coronary Atherosclerotic Plaque Burden Assessed by Coronary Computed Tomography Angiography (CCTA).

IntroductionAccording to CDC there are 88.0 million Americans aged 18 years or older with prediabetes. Cardiovascular disease is the primary cause of morbidity and mortality in diabetes. The relationship between prediabetes and coronary atherosclerosis is not well established. We evaluated the association between prediabetes and coronary atherosclerosis and compared it to non-diabetic population. MethodsIn this retrospective study all patients who underwent CCTA and coronary artery calcium (CAC) testing at our outpatient imaging center for the past 5 years were screened. 253 patients had recorded HbA1c values and were included in the study. 256 slice multi detector CT (GE Revolution, Milwaukee WI) scanner was used for imaging. CAC was scored using non-contrast CT. Total plaque score (TPS) and total stenosis score (TSS) were quantified using coronary CTA. Each of the scores were compared between prediabetic (125) and non-diabetic groups (128). ResultsMean age of the study cohort was 53.2 ± 17.1 years, 66% were males, 114 had hyperlipidemia (45%), 108 had hypertension (43%), 96 were present smokers (38%) and the mean HbA1c was 5.6 ±0.4. In multivariate adjusted regression models, the odds of TPS (OR:2.93; CI: 1.54,5.57) P<0.001, TSS (OR:2.82; CI:1.48,5.38) P<0.002 and CAC score (OR:3.43; CI: 1.74,6.74) p<0.001, were all higher in prediabetic patients. ConclusionOur findings suggest that prediabetics have higher atherosclerotic plaque burden compared to non-diabetics. In prediabetes, increased plaque burden most likely contributes to cardiovascular events. The application of these findings may guide early screening and pharmacological prevention strategies for atherosclerosis in patients with prediabetes.

Associations of plasma 8-iso-prostaglandin F2\u03b1levels with fasting blood glucose (FBG) and intra-abdominal fat (IAF) area in various Glycometabolism populations

BackgroundThis study aimed to investigate the differences in oxidative stress (OS) levels represented by 8-iso-prostaglandin F2α (8-iso-PGF2α) and analyze its correlation with the intra-abdominal fat (IAF) area and the glycolipid index.MethodsWe recruited a total of 160 eligible subjects. According to the blood glucose levels and the T2DM duration, subjects were divided into three groups: Type 2 Diabetes (T2DM) group, Prediabetic group, and Normal glucose-tolerance (NC) group, containing 66, 41, 53 patients, respectively. T2DM groups were additionally divided into a new-onset T2DM group including 29 patients and a non-new-onset T2DM group including 37 patients. General clinical data and biochemical indicators were collected. Intra-abdominal fat (IAF) was measured by MRI. 8-iso-PGF2α was measured by ELISA.ResultsCompared with the NC group, levels of systolic blood pressure (SBP), waist-to-hip ratio (WHR), FBG, 2 h postprandial glycemia(2hPG), 2 h insulin (2 h INS), IAF area, HOMA-IR, and 8-iso-PGF2α increased, and high-density lipoprotein cholesterol (HDL-C) decreased in T2DM groups and Prediabetic group (P < 0.05). The 2 h INS level was the highest in the Prediabetic group; 2hPG, and IAF area were the highest in the new-onset T2DM group; WHR, FBG, HOMA-IR and 8-iso-PGF2α were the highest in the non-new-onset T2DM group. Multiple stepwise regression analysis identified IAF area and FBG as the strongest and independent determinant of 8-iso-PGF2α (P < 0.01).ConclusionsIn various glycometabolism populations, 8-iso-PGF2α is significantly correlated with FBG and IAF, this suggests that high blood glucose and abdominal obesity can increase the damage related to the OS in vivo.

Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study.

BackgroundThe prognostic value of anthropometric, adipokine, and computed tomography measures of adiposity to predict diabetes in Black, specifically by normoglycemia versus prediabetes, remains incompletely understood.Methods and ResultsAmong Black participants without diabetes in the JHS (Jackson Heart Study), waist circumference [WC], body mass index, adiponectin, leptin, and leptin:adiponectin ratio were standardized in sample 1 (2422 participants at baseline [2000–2004]) and WC, body mass index, visceral adipose tissue (VAT), subcutaneous adipose tissue, and liver attenuation in 1537 participants at examination 2 (2005–2008) (sample 2). Hazard ratios (HRs) for diabetes were estimated using interval‐censored Cox modeling adjusting for traditional risk factors and validated with the C index. Over 5 years, 300 and 122 incident diabetes cases occurred in sample 1 and sample 2, respectively. In sample 1 and sample 2, a 1‐SD higher log‐leptin:adiponectin ratio and VAT had the strongest associations (HR, 1.95 [95% CI, 1.67–2.27] and 1.76 [95% CI, 1.52–2.04]) and discriminatory power (C index 0.68 [95% CI, 0.64–0.71] and C index 0.67 [95% CI, 0.61–0.74]) with diabetes. The normoglycemic compared with the prediabetes group had a 1.3 to 1.9 times greater magnitude of associations with diabetes for WC, liver attenuation, and VAT (P interaction <0.10). In sample 2, C indices for WC (HR, 0.84; 95% CI, 0.73–0.95), VAT (HR, 0.91; 95% CI, 0.85–0.98), and liver attenuation (HR, 0.90; 95% CI, 0.77–1.00) were greater than HbA1c (HR, 0.74; 95% CI, 0.57–0.90) in normoglycemia, whereas HbA1c was best in prediabetes (HR, 0.72; 95% CI, 0.66–0.78).ConclusionsOverall, among Black adults, multiple measures of adiposity were associated with incident diabetes with modest predictive ability. In Black patients with normoglycemia, WC, liver attenuation, and VAT may appropriately identify those at high risk for diabetes, whereas HbA1c was the best predictor in individuals with prediabetes.

Evaluation of α-klotho, FGF-23 and Insulin Resistance in Obese Prediabetics

Aim: Prediabetes is a condition with hyperglycemia and risk of development type 2 diabetes mellitus (T2DM). The aim of this study is to determine the concentrations of blood pressure, serum lipoproteins, glucose and insulin levels as well as the concentrations of α-klotho and FGF-23 parameters. We also aim at the correlation between all these parameters in obese prediabetics and obese normoglycemics. Material methods: A total of 26 obese normoglycemic (control group) and 25 obese prediabetic individuals were included in this study. Glucose, haemoglobin A1c (HbA1c) and cholesterols levels were analyzed as part of a routine procedure in the biochemistry laboratories of our hospital using an autoanalyzer. In order to determine α-klotho and fibroblast growth factor-23 (FGF-23) levels, ELISA method was used. Result: According to the findings, a significant increase was detected in serum LDL-C, TC, HbA1c, glucose, insulin and HOMA-IR levels in the obese prediabetic group compared to the control group (p <0.05). However, serum α-klotho and FGF-23 levels were found to be significantly lower in the obese prediabetic group compared to the control group (p <0.05). α-klotho and FGF-23 values showed strong negative correlation when compared with HOMA-IR values separately (p <0.01). Conclusion: These findings suggest that α-klotho and / or FGF-23 parameters may be a marker for prediabetes. The results of our study, together with the future studies, will make a significant contribution to the literature, as prediabetes diagnostic criteria in the diabetes outpatient clinics.

Proinflammatory lipid signals trigger the health effects of air pollution in individuals with prediabetes

Individuals with metabolic disorders exhibit enhanced susceptibility to the cardiovascular health effects of particulate air pollution, but the underlying mechanisms are not yet understood. We aim to assess whether changes in proinflammatory lipid signals are associated with fine particulate matter (PM2.5) exposure in individuals with and without prediabetes. A longitudinal panel study was conducted in Beijing, China, and included 120 participants followed up over 589 clinical visits from August 2013 to February 2015. We measured 12 lipids derived from arachidonic acid pathways in blood samples of the participants via targeted lipidomic analyses. Ambient PM2.5 concentrations were continuously monitored at a station for associations with the lipids. Among the 120 participants, 110 (mean [SD] age at recruitment, 56.5 [4.2] years; 31 prediabetics) who visited the clinic at least twice over the follow-up period were assigned exposure values of the outdoor residential PM2.5 concentrations during the 1–14 days preceding each clinical visit. With an interquartile range increase in the 1-day-lag PM2.5 exposure (64.0 μg/m3), the prediabetic group had consistently greater increases in the concentration of arachidonate metabolites derived from the cytochrome P450 (CYP450) pathway (5,6-DHET, 15.8% [95% CI, 3.5–29.7%]; 8,9-DHET, 9.7% [95% CI, 0.6–19.6%]; 11,12-DHET, 8.3% [95% CI, 1.9–15.1%]; 14,15-DHET, 7.4% [95% CI, 0.9–14.4%]; and 20-HETE, 8.9% [95% CI, 1.0–17.5%]), compared with the healthy group. Among CYP450-derived lipids, 14,15-DHET and 20-HETE significantly mediated 8% and 8% of the PM2.5-associated increase in white blood cells, 10% and 13% of that in neutrophils, and 20% and 23% of that in monocytes, respectively, in the prediabetic group. In conclusion, proinflammatory lipid signals from CYP450 pathways triggered the health effects of particulate air pollution in individuals with prediabetes, suggesting that targeting lipid metabolism has therapeutic potential to attenuate or prevent the cardiovascular effects of air pollution in susceptible populations.