Risk Of Type 2 Diabetes Mellitus Research Articles

Visceral adiposity index, cardiorespiratory fitness, and fasting plasma glucose associations in adolescents

BACKGROUND The global rise in the prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is partly linked to the increasing rates of childhood obesity and physical inactivity. AIM To explore the independent relationships of visceral adiposity index (VAI) and cardiorespiratory fitness (CRF) with fasting plasma glucose (FPG) in adolescents. METHODS This descriptive cross-sectional study included 403 adolescents (202 boys and 201 girls) aged 11-19 years. Participants were evaluated for VAI, CRF, and FPG. Regression models, adjusted for age and maturity status, were used to assess the associations between VAI, CRF, and FPG. RESULTS The prevalence of T2DM risk was 15.3% (girls = 7.4%; boys = 7.9%). In boys, high VAI was positively associated with FPG (β = 0.190, P = 0.009), while low CRF was negatively associated with FPG (β = -0.206, P = 0.010). These associations persisted even after adjusting for CRF and VAI. However, no significant associations between VAI, CRF, and FPG were observed in girls (P > 0.05). Adolescents with high VAI and low fitness levels demonstrated poorer glycemic profiles. CONCLUSION Among boys, both VAI and CRF were independently associated with T2DM risk, with CRF showing a stronger association. These associations were not observed in girls. Promoting regular aerobic exercise and healthy diets may serve as essential public health promotion strategies in preventing and managing T2DM risk in adolescents.

Exposure to air pollution and the risk of type II diabetes mellitus: a time-series study

BackgroundEnvironmental factors have been identified as primary risk factors for type 2 diabetes mellitus (T2DM). However, studies on the association between environmental factors and T2DM have mainly focused on morbidity and mortality, which do not fully reflect the disease burden stemming from air pollution. Therefore, we aimed to evaluate the correlation between air pollution and T2DM, including hospital length of stay (LOS) and costs.MethodsWe collected data on patients with T2DM from three healthcare institutions in Xinxiang from 2016–2021. Data on particulate and gaseous pollutants in Xinxiang and daily meteorological data were collected from national databases. The distribution lag nonlinear model was used to evaluate the correlation between air pollution and the number of inpatients with T2DM, LOS, and hospital costs. Subgroup analyses were conducted to identify potential modifying factors.ResultsOverall, 13,797 patients with T2DM were included in our analysis. Within the cumulative lag of 7 days, with every increase of 1 mg/m3 of carbon monoxide (CO) and 10 μg/m3 of 2.5 microns particulate matter, nitrogen dioxide and ozone exhibited significant associations with an increase in diabetes hospitalization risk. CO exhibited adverse effects on LOS on most lag days. Moreover, hospital costs were significantly associated with the attributable fraction of LOS and hospital costs attributed to diabetes.ConclusionsExposure to air pollutants increased T2DM risk, imposing significant economic and social burdens in Xinxiang, China. Implementing policies to reduce air pollutant exposure may decrease T2DM admissions, costs, and LOS.

Elevated lipid accumulation product trajectory patterns are associated with increasing incident risk of type 2 diabetes mellitus in China

PurposeOur study aimed to identify the trajectory patterns of lipid accumulation product (LAP) and investigate their association with the incident risk of type 2 diabetes mellitus (T2DM) in China. MethodsThis study included 37,316 eligible participants, with data collected between1998 and 2021. The LAP trajectory patterns were identified through latent mixture modeling. Logistic regression models were used to examine the association between different LAP trajectory patterns and the incident risk of T2DM. ResultsOver an average period of 12.7 years, 3195 participants developed T2DM. Four LAP trajectory patterns were identified: low stable, moderate slow-increasing, high decreasing, and moderate fast-increasing. After adjusting for demographic and clinical confounders, the odds ratios (ORs) and 95 % confidence intervals (CIs) for T2DM were 1.67 (1.50, 1.86) for the moderate slow-increasing group, 1.63 (1.38, 1.94) for the high decreasing group, and 2.43 (2.07, 2.85) for the moderate fast-increasing group compared with the low stable group. Similar trajectory patterns were found in sex-specific populations as in the general population, while the elevated LAP trajectory pattern was more strongly associated with an increase in the incident risk of T2DM in females. ConclusionIndividuals with moderate fast-increasing LAP trajectory patterns had a 2.4 times higher risk of developing T2DM compared to those with low stable LAP patterns. More attention should be paid to preventing T2DM in people with high levels of LAP, especially females, the elderly, drinkers, and people with a history of diabetes.

Flat oral glucose tolerance test during pregnancy and risk for type 2 diabetes - a five-year cohort study.

To evaluate the risk of type 2 diabetes mellitus (T2DM) in women with flat response in the 100-gram oral glucose tolerance test (OGTT) performed during pregnancy in a large cohort of women with up to 5 years of follow-up. A retrospective analysis of women with documented OGTT during pregnancy and T2DM data up to 5 years after pregnancy. Gestational diabetes (GDM) screening was done by two-step strategy. Glucose levels during pregnancy were extracted from the computerized laboratory system of Meuhedet HMO and cross-tabulated with the Israeli National Diabetes Registry. Flat OGTT was defined as fasting glucose < 95mg/dl and 3 postprandial values lower than 100mg/dl. The cohort was stratified by OGTT results to normal glucose values, flat OGTT, and GDM according to Carpenter & Coustan thresholds. Cumulative risk for T2DM was evaluated and compared between groups. Statistical analysis included univariate analysis followed by survival analysis. 14,122 parturients entered analysis. Of them, 965(6.8%) had flat OGTT, 11,427(80.9%) had normal OGTT, and 1,730(12.3%) had GDM. Women with flat OGTT were younger, had lower BMI, and lower rates of hypertension. Their glucose values throughout pregnancy were lower compared to the other groups (p<0.001 for all). During the study period and following adjustment to maternal age, obesity, and hypertension, women with flat OGTT had a low incidence of T2DM, even when compared to women with normal OGTT (aHR 0.212, 95% CI 0.052-0.856). Parturients with flat OGTT during pregnancy are at low risk of developing T2DM up to 5 years following pregnancy.

Serum metabolomic profiling of incident type 2 diabetes mellitus in the Multi-Ethnic Study of Atherosclerosis and Rotterdam Study.

This study aimed to investigate serum metabolomic biomarkers associated with incident type 2 diabetes mellitus (T2DM) and evaluate their performance in improving T2DM risk prediction. Untargeted proton nuclear magnetic resonance (1H NMR) spectroscopy-based metabolomics analyses were conducted in the Multi-Ethnic Study of Atherosclerosis (MESA; n=3460; discovery cohort) and Rotterdam Study (RS; n=1556; replication cohort). Multivariable cause-specific hazards models were used to analyze the associations between 23,571 serum metabolomic spectral variables and incident T2DM. Replicated metabolites required an FDR-adjusted P<0.01 in MESA, P<0.05 in RS, and consistent direction of association. Pathway and network analyses were conducted to elucidate biological mechanisms underlying T2DM development. Utility of the replicated metabolites in improving T2DM risk prediction was assessed based on the Framingham Diabetes Risk Score. A 2-sample Mendelian randomization was conducted to assess causal associations. Nineteen metabolites were significantly associated with incident T2DM. Pathway analyses revealed disturbances in aminoacyl-tRNA biosynthesis, metabolism of branched-chain amino acids (BCAAs), glycolysis/gluconeogenesis, and glycerolipid metabolism. Network analyses identified interactions with upstream regulators including p38 MAPK, c-JNK, and mTOR signaling pathways. Adding replicated metabolites to the Framingham Diabetes Risk Score showed modest to moderate improvements in prediction performance in MESA and RS, with Δ c-statistic of 0.05 (95% CI, 0.04-0.07) in MESA and 0.03 (95% CI, 0.01-0.05) in RS. Genetically increased BCAAs and mannose were associated with T2DM. 1H NMR measured metabolites involved in aminoacyl-tRNA biosynthesis, BCAA metabolism, glycolysis/gluconeogenesis, and glycerolipid metabolism were significantly associated with incident T2DM and provided modest to moderate predictive utility beyond traditional risk factors.

Relationship between trajectory of Chinese visceral adiposity index and risk of type 2 diabetes mellitus: Evidence from the China-PAR project.

This study aimed to identify the distinct change trajectories of the Chinese visceral adiposity index (CVAI) over time and to investigate their associations with risk of type 2 diabetes mellitus (T2DM). This study included 52 394 participants from the prospective project, the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). The CVAI was calculated using measures of age, body mass index, waist circumference, triglycerides and high-density lipoprotein cholesterol. Latent mixture modelling was conducted to fit distinct trajectory patterns. The logistic regression model was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of T2DM with various CVAI trajectory patterns. Four distinct CVAI trajectory patterns were identified: low-increasing, moderate-increasing, moderate high-increasing and high-increasing. Compared with low-increasing CVAI, participants with moderate-increasing (OR 1.73, 95% CI 1.49-2.00), moderate high-increasing (3.48, 3.01-4.03) and high-increasing CVAI (5.50, 4.67-6.47) had a significantly increased risk of T2DM. Similar trajectory patterns were identified in both men and women. The ORs (95% CI) for moderate-increasing, moderate high-increasing and high-increasing groups were 3.28 (2.56-4.19), 7.85 (6.09-10.13) and 13.21 (9.98-17.49) in women respectively, and 1.20 (0.99-1.45), 2.18 (1.82-2.62) and 3.60 (2.93-4.43) in men respectively, when compared to the low-increasing CVAI group. Further, significant effect modifications for age, smoking and physical activity (all Pinteraction <0.05) were observed in the relationship between CVAI trajectory patterns and T2DM. Initially high and persistently elevated CVAI is significantly associated with an increased risk of T2DM, with a particular focus on women, younger people, nonsmokers and physically inactive individuals. Continuous monitoring of CVAI levels will benefit effective identification, early intervention and management of individuals at high risk of T2DM.

Association Between Nontraditional Lipid Profiles and the Risk of Type 2 Diabetes Mellitus in Chinese Adults With Hypertension: Findings From the China Hypertension Registry Study.

The relationship between nontraditional lipid profiles and type 2 diabetes mellitus (T2DM) remains ambiguous within the hypertension population. The objective of this study is to examine the association between nontraditional lipid profiles and T2DM in Chinese adults with hypertension. The current investigation encompassed 13728 participants with hypertension from the China Hypertension Registry Study. Logistic regression analysis and smooth curve fitting were employed to evaluate the association between nontraditional lipid profiles and T2DM. The prevalence of T2DM was found to be 17.8%. In the fully adjusted model, atherogenic index of plasma (AIP) exhibited the highest odds ratios (ORs) for T2DM (OR: 2.71, 95% confidence interval [CI]: 2.26-3.26). Conversely, the fully adjusted ORs (95% CI) for total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (Non-HDL-C) were 1.33 (1.25-1.41), 1.40 (1.29-1.51), and 1.41 (1.34-1.49), respectively. Additionally, the study demonstrated that AIP had a superior ability to identify T2DM. Subgroup analyses indicated that the relationship between AIP and Non-HDL-C with T2DM was more significant in the lighter weight population. In addition, the association of TC/HDL-C with LDL-C/HDL-C with T2DM was stronger in the lower homocysteine level population. Among the southern Chinese population with hypertension, all nontraditional lipid indices positively correlated with the risk of T2DM. Among these lipid indices, AIP exhibited superior discriminatory power in identifying T2DM compared to TC/HDL-C, LDL-C/HDL-C. Trial Registration: ChiCTR1800017274.

Alterations in the Levels of Urinary Exosomal MicroRNA-183-5p and MicroRNA-125a-5p in Individuals with Type 2 Diabetes Mellitus.

Background: Type 2 diabetes mellitus (T2DM) is a metabolic disorder, and urinary exosomal microRNAs (miRNAs) were utilized as potential disease prediction or diagnostic biomarkers in numerous studies. This study investigated the differential expression of urinary exosomal miRNAs between non-diabetes mellitus (NDM) individuals and those with T2DM. Aim: To elucidate the association between urinary exosomal miRNAs and T2DM. Methods: We recruited patients diagnosed with T2DM and NDM individuals in West China Hospital, Sichuan University, from November 2023 to February 2024. Subsequently, we performed sequencing of urinary exosomal microRNAs in both groups. The obtained sequencing results were further validated using RT-qPCR in both the training set and the validation set. Additionally, we conducted logistic regression analysis and Spearman correlation analysis on miRNAs with significant differential expression, as well as analysis of their biological functions. Results: A total of 118 urine samples were collected, 59 from individuals diagnosed with T2DM and 59 from NDM. There were differentially expressed miR-183-5p (p = 0.034) and miR-125a-5p (p = 0.008) between the two groups. Furthermore, multivariate regression analysis demonstrated that higher miR-125a-5p levels were negatively associated with the risk of T2DM (p = 0.044; OR: 0.046; 95% CI: 0.002, 0.922). Bioinformatics analysis indicated that the target genes of miR-183-5p were predominantly involved in insulin signaling and glucose transport processes, while those target genes of miR-125a-5p primarily mediated autophagy. Conclusions: miR-183-5p and miR-125a-5p might be involved in the pathogenesis of T2DM, while higher urinary exosomal miR-125a-5p was negatively associated with the risk of T2DM.

Exploring Risk Factors of Type 2 Diabetes Mellitus Using Decision Tree and Random Forest Models: Baseline Data From Kharameh Cohort Study

Background and aims: Identifying subjects that are at risk of type 2 diabetes mellitus (T2DM) and predicting the associated risk factors are highly important. Thus, this study aimed to explore the risk factors and find the prediction model for T2DM using decision trees (DTs) and random forest (RF) models. Methods: This cross-sectional study is a part of the Kharameh Cohort Study. Kharameh Cohort is a part of the Fars Cohort, which started in 2014 with 10663 people aged 40–70. In this study, the risk factors of T2DM were explored using two data mining methods. Accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were applied to evaluate the models. The data were statistically analyzed using R software. Results: The DT modeling showed that age, triglycerides (TG), physical activity, systolic blood pressure, low-density lipoproteins (LDL), and body mass index (BMI) were the most associated factors in D2MT, while applying RF revealed that fasting blood sugar, cholesterol, creatinine, TG, gamma-glutamyl transferase physical activity, BMI, and LDL were the most effective on T2DM. The RF model was superior to the DT based on the applied criteria. Sensitivity, specificity, accuracy, and AUC for the RF were 73.4, 70.10, 73.5, and 79.1. These findings for the DT were 63.8, 69.7, 62.8, and 66.8, respectively. Conclusion: Based on the inferences, a strong association was found between several risk factors and the risk of T2DM. Therefore, predictive analytics using the RF model can be applied to identify the risk factors of other chronic diseases.

Targeting the cholinergic anti-inflammatory pathway for type 2 diabetes prevention: A retrospective cohort study.

Chronic inflammation is a key factor in type 2 diabetes mellitus (T2DM) development. The cholinergic anti-inflammatory pathway (CAP) reduces inflammation by activating α7 nicotinic acetylcholine receptors (α7nAChRs) on macrophages, suppressing proinflammatory cytokines. Acetylcholinesterase inhibitors (AChEis), primarily used for Alzheimer's disease (AD), may exert anti-inflammatory effects through the CAP. One AChEi, galantamine, also directly agonizes α7nAChRs, potentially enhancing its anti-inflammatory properties. This study aimed to investigate the association between AChEi use, particularly galantamine, and T2DM risk in AD patients. We conducted a retrospective analysis of Veterans Health Administration (VA) data, examining early- and late-onset AD patients receiving galantamine or other AD medications. Propensity score matching was used to balance groups and minimize confounding. Cox proportional hazard models assessed T2DM risk for galantamine, other AChEis and memantine. A total of 40 065 AD patients were included in the study. Among early-onset AD patients, galantamine use significantly reduced T2DM risk (hazard ratio [HR] = 0.80, 95% confidence interval [CI]: 0.66-0.98). Memantine also showed a protective effect (HR = 0.82, 95% CI: 0.69-1) in this group. Neither galantamine nor memantine influenced T2DM risk in late-onset AD. Other AD medications showed no association with T2DM risk. Galantamine use was associated with a lower risk of T2DM in early-onset AD patients, potentially due to enhanced anti-inflammatory effects through both AChE inhibition and direct α7nAChR agonism. Memantine also demonstrated a protective effect. These findings suggest potential new applications for existing AD medications in T2DM prevention, particularly in early-onset AD patients. Further research, including randomized controlled trials with diverse populations, is needed to confirm these results and the underlying mechanisms.

The Relationship between Dietary Habits and Type 2 Diabetes for Contribution to Health Promotion: Literature Review

Introduction: Type 2 Diabetes Mellitus (T2DM) is a chronic condition largely influenced by dietary habits and eating behaviors. Poor dietary choices, such as high consumption of refined sugars, unhealthy fats, and low intake of fiber, are well-established risk factors for the development of T2DM. The promotion of healthy eating behaviours and active lifestyles is essential to address the increasing prevalence of T2DM and improve public health. Objective: This study aimed to examine the impact of various dietary patterns and specific food intakes on the risk of T2DM, as well as the role of meal timing and dietary quality in influencing blood glucose levels and insulin sensitivity. Method: This research employs a literature review method by analyzing several relevant studies. The articles were sourced from Scopus and Google Scholar, using keywords such as "feeding behavior," "eating behavior," "feeding patterns," "food habits," "dietary habits," and "type 2 Diabetes," "diabetes Type 2," "type 2 diabetes mellitus," "diabetes mellitus type 2," and "T2DM." Result: The results of the article search revealed 13 articles from 2019-2024 that matched the criteria set. The results showed that Eating habits have a significant effect on the risk of developing Type 2 Diabetes Mellitus (T2DM). Poor food choices and irregular eating patterns increase the risk. Conclusion: The paper highlights the significant impact of dietary habits and eating behaviors on the development and progression of Type 2 Diabetes Mellitus. It emphasises the importance of healthy food choices and regular eating patterns in managing blood glucose levels and insulin sensitivity. These insights could contribute to designing an effective health promotion program.

Association between body mass index trajectories and type 2 diabetes incidence over an 18-year follow-up in the Tehran Lipid and Glucose Study

Body mass index (BMI) is a well-known risk factor for type 2 diabetes mellitus (T2DM). We aimed to identify BMI trajectory patterns and evaluate their association with T2DM during 18 years of follow-up. We included 6026 participants aged 20 to 65 from the prospective population-based Tehran Lipid and Glucose Study (TLGS). The BMI trajectory patterns were identified using latent growth mixture modeling (LGMM) during the measurement period. The association between the BMI trajectory patterns and future T2DM was evaluated using the Cox proportional hazard regression models. Three BMI trajectory patterns of low-increasing (38.6%), medium-increasing (47.1%), and high-increasing (14.3%) were detected. The participants in the medium-increasing and high-increasing BMI trajectory groups had HRs of 1.87 (95% CI 1.53–2.28) and 3.41(95% CI 2.71–4.29) for T2DM incidence, respectively. Within the normoglycemic subpopulation, the high-increasing BMI group had an HR of 3.82 (95% CI 2.79–5.24) compared to the low-increasing BMI group, while in the prediabetic subpopulation, the high-increasing BMI group had an HR of 2.93 (95% CI 2.04–4.19) compared to the low-increasing BMI group. Body weight varies in a relatively stable pattern in adulthood over the long-term period. Medium and high-increasing BMI trajectory patterns have a significantly increased risk for future T2DM in both normoglycemic and prediabetic individuals. Identifying BMI trajectory patterns can help healthcare providers in early prediction, risk assessment, and monitoring strategies development for the prevention of T2DM.

Potassium inwardly-rectifying channel subfamily J member 11 (KCNJ11) gene polymorphism in Egyptian type 2 diabetic patients: a single-center study.

The KCNJ11 gene belongs to the potassium channel gene family. It has a major role inthe secretion of insulin. Genetic variations in KCNJ11 are possibly responsible for the progression of type 2 diabetes mellitus (T2DM). In this study, we investigated the possible correlation between KCNJ11 (rs5210) gene polymorphism and T2DM. This study included 92 individuals divided into two groups. Group 1 included 46 type 2 diabetic patients. Group 2 (control group) included 46 healthy participants. A complete history was taken and a full physical examination was performed. Anthropometric data were measured. Laboratory investigations included fasting blood glucose (FBG), two hours post-prandial blood glucose (2HPPBG), glycated hemoglobin (HbA1c), and fasting lipid profile. KCNJ11 (rs5210) single nucleotide polymorphism was detected by polymerase chain reaction restriction-fragment length polymorphism (PCR-RFLP). Both AG and GG genotypes were associated with increased risk for T2DM (OR 5.2, 95% CI 1.32-20.5, P = 0.01 for AG; and OR 18.2, 95% CI 2.99-31.7, P = 0.002 for GG). Also, the frequency of the G allele was significantly higher in type 2 diabetic patients compared to healthy controls (50% versus 23.9%, respectively). The G allele of rs5210 in KCNJ11 contributed to an increased risk of T2DM (OR 3.18, 95% CI 1.31-7.75, P = 0.01). There was a statistically significant association between increased 2HPPBG and HbA1c levels and the carrier of AG and GG genotypes (P = 0.01 and 0.007, respectively). There was a statistically significant association between total cholesterol(TC), low-density lipoprotein-cholesterol (LDL-c), and high-density lipoprotein-cholesterol (HDL-c) levels and the carrier of AG and GG genotypes (P < 0.001, 0.02, and 0.007, respectively). Regression analysis detected that body mass index (BMI), 2HPPBG, TC, triglycerides (TG), and the G allele of rs5210 in KCNJ11 gene showed a significant association with T2DM (P = 0.004, 0.042, 0.003, 0.006, and 0.01, respectively) while no association was observed with FBG, HbA1c, LDL-c or HDL-c (P = 0.099, 0.123, 0.522, and 0.765, respectively). KCNJ11 rs5210 genetic polymorphism may raise the risk for the occurrence ofT2DM among Egyptians.

Association of intrinsic capacity with incident type 2 diabetes mellitus in older Chinese: Guangzhou Biobank Cohort Study

BackgroundThe World Health Organization introduced intrinsic capacity (IC) as a metric for healthy aging. However, we found no report on the association between IC and type 2 diabetes mellitus (T2DM). We investigated the association between IC and incident T2DM in older Chinese from the Guangzhou Biobank Cohort Study. MethodsIC was assessed across five domains equally: locomotion, vitality, cognition, psychological and sensory. Composite IC scores (0-10) were classified into three groups: poor (0-5.9), fair (6.0-8.9), and high (9.0-10), with higher scores representing greater IC. Multivariable linear regression and cox regression was used to analyze the association between IC with glycemia and T2DM, respectively. ResultsOf 3582 participants with a mean age of 59.1 years (standard deviation (SD)=7.13) without baseline diabetes, during an average follow-up of 3.3 years (SD=0.86), 497 (13.87%) developed T2DM. After adjustments for potential confounders, those with baseline poor IC, versus high, had higher fasting glucose, 2-hour post-load glucose and glycosylated hemoglobin A1c at follow-up, and a higher risk of incident T2DM (HR (95%CI): 1.80 (1.20, 2.72)). Among IC domains, only vitality impairment was associated with an increased risk of T2DM (P for trend < 0.001). ConclusionWe first reported the prospective associations of poor IC and vitality with higher glycemia and incident T2DM risk. Enhancing muscle strength to improve functional ability may be a possible intervention for reducing future risk of T2DM in older populations.

Non-dioxin-like polychlorinated biphenyls (NDL-PCBs) dietary exposure is associated with an increased risk of type 2 diabetes in the European prospective investigation into cancer and nutrition (EPIC) cohort

Aims/hypothesisThe aim of the present study was to investigate the association between dietary exposures to dioxins, dioxin-like polychlorinated biphenyls (DL-PCBs) and non-dioxin-like polychlorinated biphenyls (NDL-PCBs) and the incidence of type 2 diabetes mellitus (T2DM) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. MethodsThis prospective cohort study with a median 11.7 years of follow-up, included 318,416 individuals recruited in 21 centers in eight countries. Dietary intake of dioxins and PCBs was calculated by combining EPIC food consumption data with food contamination data from the European Food Safety Authority (EFSA). To identify incident cases of T2DM, a thorough review of various sources including self-reported information, linkage to primary and secondary care registers, drug registers, hospital admissions, and mortality data was conducted. Associations between dietary intake of dioxins and PCBs and T2DM were evaluated using multivariable Cox regressions. ResultsHigher T2DM risk was observed for higher estimated dietary intake of non-dioxin-like PCBs (NDL-PCBs; HR per 1 SD increment = 1.03 [95 %CI 1.01;1.04], and HR (Q4vs Q1) = 1.15 [1.08;1.22], P-trend < 0.001). The results were consistent in analyses stratified by gender, body mass index, country, median follow-up, or self-reported hypertension and hyperlipidemia, as well as when adjusting for fat intake. No consistent association was observed between dioxins+DL-PCBs intake and T2DM risk. Conclusion / interpretationResults obtained in this large European prospective study indicate a positive and linear association between dietary intake of NDL-PCBs and risk of T2DM. This association remained consistent across various stratified and sensitivity analyses. Further studies are warranted to better understand the biological mechanisms underlying this association.

Dependent censoring bias assessment using inverse probability of censoring weights: Type 2 diabetes mellitus risk in patients initiating bisoprolol versus other antihypertensives in a Clinical Practice Research Datalink cohort study.

Dependent censoring involves a preferential attrition of a subgroup of interest; occurring in survival analysis, it may impact interpretation by introducing a selection bias. To assess the potential bias in a comparison of bisoprolol to other antihypertensives in terms of Type 2 diabetes mellitus (T2DM) incidence, inverse probability of censoring weights (IPCW) was used. It was further used to contextualize results obtained through competing risks analysis. Two estimands were considered to assess T2DM incidence while accounting for deviations from the initial antihypertensive monotherapy (DFM). A hypothetical estimand using IPCW, treating DFM as censoring, was interpreted together with a 'while-on-treatment' estimand, treating DFM as a competing risk. We illustrated our application with a cohort study based on Clinical Practice Research Datalink (CPRD) including 267,352 patients with newly diagnosed arterial hypertension between 2000 and 2017, initiating antihypertensive monotherapy among bisoprolol, other beta-blockers, renin-angiotensin system drugs (ACEi/ARB), diuretics and calcium-channel blockers. A mild dependent censoring process was hypothesized, leading to slight overestimation of T2DM incidence. Although subject to some limitations, a nonsignificant trend toward an excess of risk associated with ACEi/ARB was yielded consistently by IPCW and competing risks analyses. Conversely, in comparisons of bisoprolol versus either diuretics, other beta-blockers or calcium channel blockers, no significant differences or critical dependent censoring impact were found. Concurrent use of complementary estimands allowed formulating a refined interpretation of our findings: though not significant, the trend toward an excess of T2DM risk associated with a ACEi/ARB monotherapy compared with bisoprolol is likely not originating only from the minor dependent censoring. Reassessing identical estimands in other cohorts would provide insights to corroborate or refute this result.

Type 2 diabetes mellitus, obesity, cesarean section delivery, and lack of exclusive breastfeeding exposure in patients from the Guadalajara Metropolitan Area, Mexico.

Introduction: the combination of cesarean section delivery and limited exposure to full breastfeeding (FBF) in the first six months of life may increase the risk of obesity and diabetes mellitus. This study aimed to establish an association between type 2 diabetes mellitus (T2DM) in adulthood, cesarean section delivery and incomplete full breastfeeding (FBF) in individuals from the metropolitan area of Guadalajara, Mexico. Methodology: this analytical cross-sectional study included patients over 18 years of age with T2DM and normal weight, overweight or obesity, regardless of sex. Informed consent was obtained. Variables encompassed T2DM, type of delivery method, first-year diet, family history, demographic, socioeconomic, and educational characteristics, and anthropometric measurements. For statistical analysis, Student's t test, chi-square tests and odds ratios were employed. Results: the study evaluated 218 patients with an average age of 57.8 years (± 12.7) and an average age at T2DM diagnosis of 46.2 years (± 12.5). FBF (65.6 %) and partial breastfeeding (PBF) (23.8 %) prevailed in the first six months. The average age at T2DM diagnosis was 46.7 years (± 12.1) for vaginally born patients and 30.7 years (± 15.5) for cesarean-born patients (p = 0.001). Cesarean delivery increased obesity risk by nine times in patients with T2DM [OR = 8.9 (CI, 1.05, 75.2), p = 0.02]. Conclusion: prioritizing the limitation of nonmedically justified cesarean section deliveries is crucial to mitigate the risk of obesity and T2DM in adulthood. .

The association between parity and type 2 diabetes mellitus: a cross-sectional, community-based study.

Limited published data exist on the association between parity (number of deliveries) and diabetes mellitus (DM). This study was conducted to evaluate the association between parity and type 2 DM (T2DM) among Sudanese women. A multistage sampling survey was conducted in four villages in the River Nile State, Sudan, between July and September 2022. The World Health Organization's three-level stepwise questionnaire was adopted to collect women's sociodemographic characteristics (age, sex, height, weight, marital status, parity, education level, occupation, detailed obstetric history, and family history of T2DM). Multivariate analyses were performed. A total of 397 women were recruited. Their median (interquartile range) age was 45.0 (33.0‒55.7) years. A total of 154 women (38.8%) were nulliparous, whereas 93 (23.4%), 70 (17.6%), and 80 (20.2%) had para 1‒3, 4 or 5, and more than 5, respectively. A total of 112 (28.2%) women had T2DM. In multivariate analysis, older age (adjusted odds ratio, AOR, 1.04, 95%, confidence interval, CI, 1.02‒1.06), high parity (AOR, 1.1, 95% C, 1.01‒1.20), and a family history of DM (AOR, 3.26, 95% CI, 1.98‒5.38) were associated with T2DM. Compared with the nulliparity, para 1‒3 (AOR, 2.33; 95% CI, 1.17‒4.61), para 4 or 5 (AOR, 2.12; 95% CI, 1.04‒4.30), and para > 5 (AOR, 2.16; 95% CI, 1.09‒4.27) were at higher risk of T2DM. In women aged < 50 years, high parity (AOR, 1.22; 95% CI, 1.06‒1.44) was associated with T2DM. Compared with the nulliparous women, para 4 or 5 (AOR, 3.47; 95% CI, 1.16‒10.34) and para > 5 (AOR, 4.63; 95% CI, 1.54‒13.87) were associated with T2DM, whereas para 1‒3 was not associated with T2DM. In the women aged ≥ 50 years, parity and parity groups were not associated with T2DM. There is a high prevalence of T2DM among Sudanese women. Parity and high parity are significant predictors of T2DM among these women in this part of Sudan.

Perspective on the health effects of unsaturated fatty acids and commonly consumed plant oils high in unsaturated fat.

Epidemiological and clinical trial evidence indicates that n-6 polyunsaturated fatty acid (PUFA) intake is cardioprotective. Nevertheless, claims that n-6 PUFA intake promotes inflammation and oxidative stress prevail. This narrative review aims to provide health professionals with an up-to-date evidence overview to provide the requisite background to address patient/client concerns about oils containing predominantly unsaturated fatty acids (UFA), including MUFA and PUFA. Edible plant oils, commonly termed vegetable oils, are derived from vegetables, nuts, seeds, fruits and cereal grains. Substantial variation exists in the fatty acid composition of these oils; however, all are high in UFA, while being relatively low in saturated fatty acids (SFA), except for tropical oils. Epidemiological evidence indicates that higher PUFA intake is associated with lower risk of incident CVD and type 2 diabetes mellitus (T2DM). Additionally, replacement of SFA with PUFA is associated with reduced risk of CVD and T2DM. Clinical trials show higher intake of UFA from plant sources improves major CVD risk factors, including reducing levels of atherogenic lipids and lipoproteins. Importantly, clinical trials show that increased n-6 PUFA (linoleic acid) intake does not increase markers of inflammation or oxidative stress. Evidence-based guidelines from authoritative health and scientific organisations recommend intake of non-tropical vegetable oils, which contain MUFA and n-6 PUFA, as part of healthful dietary patterns. Specifically, vegetable oils rich in UFA should be consumed instead of rich sources of SFA, including butter, tallow, lard, palm and coconut oils.

Childhood socioeconomic differences in type 2 diabetes: longitudinal results of The Maastricht study

Abstract Background Type 2 diabetes mellitus (T2DM) is a common chronic disease that disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have an increased risk of developing T2DM. Knowing the potential influence of early life on T2DM risk later in life, this study aims to examine longitudinal associations between childhood SEP and type 2 diabetes, independent of adult SEP. Methods Longitudinal data was used from 6,727 participants of The Maastricht Study without T2DM at baseline (participants with prediabetes were included in the study sample). T2DM status was determined by a standardized oral glucose test. Sample mean (SD) age was 58.7 (8.7) years and 55.2% was female. Childhood SEP was determined by the highest level of completed education for father and mother and a measurement for childhood income inadequacy. Adult SEP was determined by the highest completed level of education, equivalent household income and occupational position. Incident T2DM was self-reported yearly. Associations were studied annually over a 12-year period (median (IQR) 8.2 (4.9) years) with Cox regression analyses. Results A total of 247 participants (3.7%) without T2DM at baseline reported incident T2DM. Incident T2DM was more common in people with low childhood SEP versus high childhood SEP (4.5% vs. 2.7%, p = 0.008) and for people with low adult SEP versus high adult SEP (5.2% vs. 2.1%, p &amp;lt; 0.001). The impact of parental education on incident T2DM is mitigated by adult SEP. Childhood income inadequacy did predict T2DM independently of adult SEP, with a HR of 1.22 (1.01, 1.45). Conclusions Socioeconomic inequalities in childhood and adulthood are both predictive for incident T2DM. Experiencing income inadequacy in childhood increases the risk of developing T2DM in later life, independent of adulthood SEP. More attention is needed for deprivation in childhood and its impact on T2DM. Key messages • People who have experienced income inadequacy as a child have a higher risk of developing T2DM in later life, independent of their adult SEP. • More attention and research is needed for the impact of childhood poverty on developing T2DM in later life.