Risk Of Type 2 Diabetes Mellitus Research Articles

The interaction between general or abdominal obesity and hypertension on the risk of type 2 diabetes mellitus: a cross-sectional analysis in Iranian adults from the RaNCD cohort study

BackgroundInteractions between risk factors may influence disease severity. Knowing this relationship is important for preventive interventions and disease control. The purpose of this study was to determine the interactions effects of obesity and hypertension on the risk of type 2 diabetes mellitus (T2DM).MethodsThe data of 9,283 adults 35 to 65 years were examined from the cohort study of Ravansar Non-Communicable Disease (RaNCD). Waist circumference (WC) was used to identify both general and abdominal obesity based on body mass index (BMI). To assess the interaction between hypertension and obesity (general/abdominal) and the risk of T2DM, the additive interaction was calculated.ResultsThe adjusted odds ratios for T2DM were 2.38 (1.67, 3.41) in men and 4.02 (2.47, 6.47) in women for the combinations of hypertension and abdominal obesity. The adjusted odds ratios for T2DM were 2.53 (1.63, 3.82) in men and 2.66 (1.92, 3.70) in women for the combinations of hypertension and general obesity. The results of the additive interaction indicators were inconsistent with gender. The relative excess risk due to interaction (interaction between hypertension and central obesity) (RERI), attributable proportion due to interaction (AP) and synergy index (SI) were0.27 (-1.01, 1.54), 0.11 (-0.41, 0.63) and 1.23 (0.41, 3.68) in male and were 0.61 (-1.12, 2.33), 0.23 (0.08, 0.37) and 1.26 (0.60, 2.61) in female, respectively.ConclusionGeneral/abdominal obesity and hypertension have a synergistic effect on the risk of T2DM. The recommendation for preventing T2DM is lifestyle modification. Large longitudinal studies are necessary to investigate causal relationships.

Association between nitric oxide synthase (NOS3) gene polymorphisms and diabetic nephropathy: An updated meta-analysis

Polymorphisms located within NOS3 gene have been investigated as susceptibility variants for diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM) in a large number of studies. However, these previous articles yielded inconsistent results and we aimed at elucidating the impact of NOS3 variants on DN risk in T2DM by conducting an updated systematic data synthesis. A total of 36 studies (12,807 participants) were selected for qualitative data synthesis, while 33 records with 11,649 subjects were included in the meta-analysis. The pooled analysis demonstrated the association of minor alleles of rs2070744 and rs1799983 with an increased susceptibility to DN (P < 0.001 and P = 0.015 for allelic model, respectively). For both of these variants, a significant effect of subgrouping according to ethnicity was found. Rs869109213 displayed an association with DN susceptibility, with pooled effect measures indicating a predisposing effect of the minor allele a (Prec = 0.002, ORrec = 1.960, 95%CI 1.288–2.983; Paavs. bb = 0.001, ORaavs. bb = 2.014, 95%CI 1.316–3.083). These findings support the effects of NOS3 variants on the risk of developing DN in T2DM.

Causal relationship between gut microbiota and diabetic nephropathy: a two-sample Mendelian randomization study.

Emerging evidence has provided compelling evidence linking gut microbiota (GM) and diabetic nephropathy (DN) via the "gut-kidney" axis. But the causal relationship between them hasn't been clarified yet. We perform a Two-Sample Mendelian randomization (MR) analysis to reveal the causal connection with GM and the development of DN, type 1 diabetes nephropathy (T1DN), type 2 diabetes nephropathy (T2DN), type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM). We used summary data from MiBioGen on 211 GM taxa in 18340 participants. Generalized MR analysis methods were conducted to estimate their causality on risk of DN, T1DN, T2DN, T1DM and T2DM from FinnGen. To ensure the reliability of the findings, a comprehensive set of sensitivity analyses were conducted to confirm the resilience and consistency of the results. It was showed that Class Verrucomicrobiae [odds ratio (OR) =1.5651, 95%CI:1.1810-2.0742,PFDR=0.0018], Order Verrucomicrobiales (OR=1.5651, 95%CI: 1.1810-2.0742, PFDR=0.0018) and Family Verrucomicrobiaceae (OR=1.3956, 95%CI:1.0336-1.8844, PFDR=0.0296) had significant risk of DN. Our analysis found significant associations between GM and T2DN, including Class Verrucomimicrobiae (OR=1.8227, 95% CI: 1.2414-2.6763, PFDR=0.0139), Order Verrucomimicrobiae (OR=1.5651, 95% CI: 1.8227-2.6764, PFDR=0.0024), Rhodospirillales (OR=1.8226, 95% CI: 1.2412-2.6763, PFDR=0.0026), and Family Verrucomicroniaceae (OR=1.8226, 95% CI: 1.2412-2.6763, PFDR=0.0083). The Eubacteriumprotogenes (OR=0.4076, 95% CI: 0.2415-0.6882, PFDR=0.0021) exhibited a protection against T1DN. Sensitivity analyses confirmed that there was no significant heterogeneity and pleiotropy. At the gene prediction level, we identified the specific GM that is causally linked to DN in both T1DM and T2DM patients. Moreover, we identified distinct microbial changes in T1DN that differed from those seen in T2DN, offering valuable insights into GM signatures associated with subtype of nephropathy.

Trajectories of social isolation and loneliness and the risk of incident type 2 diabetes mellitus across genetic risk score

AimThis study aimed to investigate the association of social isolation, loneliness, and their trajectory with the risk of developing type 2 diabetes mellitus (T2DM) across genetic risk. MethodsWe included 439,337 participants (mean age 56.3 ± 8.1 years) enrolled in the UK Biobank study who were followed up until May 31, 2021. Social isolation and loneliness were self-reported and were further categorized into never, transient, incident, and persistent patterns. ResultsDuring a median follow-up of 12.7 years, 15,258 incident T2DM cases were documented. Social isolation (versus no social isolation: hazard ratio (HR) 95 % confidence interval (CI) 1.04 [1.00;1.09]) and loneliness (versus no loneliness: 1.26 [1.19;1.34]) were associated with an increased T2DM risk, independent of the genetic risk for T2DM. The interactions existed between social isolation and loneliness (Pinteraction < 0.05); the increased T2DM risk associated with social isolation was only significant among participants without loneliness. In the longitudinal analysis, only persistent social isolation (versus never social isolation: 1.22 [1.02;1.45]) was associated with an increased T2DM risk, whereas incident loneliness (versus never loneliness: 1.95 [1.40;2.71]) and persistent loneliness (2.00 [1.31;3.04]) were associated with higher T2DM risks. ConclusionSocial isolation and loneliness, especially their persistent pattern, were independently associated with an increased incident T2DM risk, irrespective of an individual's genetic risk. Loneliness modified the association between social isolation and incident T2DM.

The Relationship Between Plasma Nickel Concentrations and Type 2 Diabetes Mellitus Risk: A Protective Effect Within a Specific Range

BackgroundNickel is considered an essential nutrient for certain microbial, plant, and animal species, but its role in human health remains controversial. Some studies have reported the relationship between nickel and type 2 diabetes mellitus (T2DM), but the results are not consistent and the mechanism is not clear, which needs further exploration. AimTo investigate the possible correlation between nickel and T2DM. MethodsWe conducted a case-control study of 192 patients with T2DM and 189 healthy controls at a hospital in central China. Plasma concentrations of nickel and six other trace elements were measured with inductively coupled plasma mass spectrometry. Logistic regression models, restricted cubic spline models (RCS), and Bayesian kernel machine regression (BKMR) were used to evaluate the relationship between plasma nickel and T2DM and its metabolic risk factors, as well as the presence or absence of interactions between nickel and other elements. ResultsThe T2DM group exhibited considerably lower plasma nickel levels than the control group (P < 0.001). Whether using a crude or adjusted model, logistic regression analysis finds a negative correlation between nickel levels and the risk of T2DM (P trend < 0.001). According to the RCS, the risk of T2DM reduces with rising nickel levels when the value is below 6.1 μg/L; nickel has a negative linear correlation with fasting plasma glucose (FPG), an inverse U-shaped connection with superoxide dismutase (SOD), and a positive linear correlation with malondialdehyde (MDA) (all P overall < 0.05). The plasma nickel concentration was positively correlated with zinc, vanadium, and chromium (r = 0.23, 0.11, and 0.19, respectively; all P < 0.05) and negatively correlated with copper (r = − 0.11, P < 0.05). In the BKMR model, interactions of nickel with zinc on T2DM and SOD, nickel with chromium on T2DM and homeostasis model assessment of β cell (HOMA-β), and nickel with copper on FPG, homeostasis model assessment of insulin (HOMA-IR), and MDA were observed. ConclusionNickel may have a dual effect on the risk of T2DM, with a protective range of less than 6.1 μg/L. Potential interactions between nickel, copper, zinc, and chromium existed in their associations with T2DM and its metabolic risk factors.

A two-sample bidirectional Mendelian randomization analysis investigates associations between gut microbiota and type 2 diabetes mellitus.

This study sought to elucidate the causal association between gut microbiota (GM) composition and type 2 diabetes mellitus (T2DM) through a comprehensive two-sample bidirectional Mendelian randomization analysis. T2DM data were sourced from the IEU OpenGWAS Project database, complemented by 211 gut microbiota (GM) datasets from the MiBioGen Federation. The primary analytical approach employed was inverse variance weighted (IVW), supplemented by MR-Egger regression and weighted median (WME) methods to investigate their potential interplay. Results were assessed using odds ratios (OR) and 95% confidence intervals (CI). The robustness and reliability of the findings were confirmed through leave-one-out analysis, heterogeneity testing, and assessment of horizontal pleiotropy. Furthermore, we explored the potential mediating role of metabolites in the pathway linking GM to T2DM. A set of 11 Single Nucleotide Polymorphisms (SNPs) linked to GM were identified as instrumental variables (IVs). The IVW analysis revealed that increased abundance of the genus Actinomyces, genus Bilophila, genus Lachnoclostridium, genus Ruminococcus gnavus group, and genus Streptococcus corresponded to a heightened risk of T2DM. Conversely, higher levels of genus Eubacterium oxidoreducens group, genus Oscillospira, genus Ruminococcaceae UCG003, genus Ruminococcaceae UCG010, and genus Sellimonas were associated with a reduced risk of T2DM. However, following false discovery rate (FDR) correction, only the abundance of genus Lachnoclostridium retained a significant positive correlation with T2DM risk (OR = 1.22, q value = 0.09), while the other ten GM showed suggestive associations with T2DM. Reverse MR analysis did not reveal any causal relationship between T2DM and the increased risk associated with the identified GM. Additionally, metabolites did not exhibit mediating effects in this context. This study effectively pinpointed specific GM associated with T2DM, potentially paving the way for novel biomarkers in the prevention and treatment of this condition. The findings suggested that probiotics could emerge as a promising avenue for managing T2DM in the future. Furthermore, the analysis indicated that metabolites do not appear to act as mediators in the pathway from GM to T2DM.

A Systematic Review on Prevention of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus

Background: Women with prior gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes mellitus (T2DM) in later life. Lifestyle interventions aimed at postpartum weight loss to reduce T2DM risk have been reported but poor compliance remains a barrier. Objectives: To assess what preventative measures reduce type 2 diabetes prevalence among women with previous gestational diabetes. Method: Search Strategy: Electronic databases CINAHL Web of Science PubMed and EMBASE were searched via the e-library gateway of the University of Nottingham using key words combined in a formal search strategy. Selection Criteria: Randomized Controlled Trials and Cluster Randomized Controlled Trials examining what preventative measures reduce type 2 diabetes prevalence among women with previous gestational diabetes were selected. Results: 14 studies were identified for inclusion in the review after a stringent criterion and their data was extracted using JBI data extraction tool. Three themes were identified across the 14 studies mainly: weight management healthy eating and medication and physical activities. Most interventions had positive outcomes however a few had no significant impact in the prevention of T2DM. Conclusion: The likelihood of developing diabetes is higher for women with a history of GDM, increases with a high BMI, high fasting glucose, impaired glucose tolerance, and elevated fasting glucose. This risk can be greatly reduced by making lifestyle adjustments or taking medication. The main risk factors that increase the risk of T2DM after GDM identified in this review were obesity, poor quality of diet and a sedentary lifestyle.

Adiponectin and HbA1c levels among Indian patients with diabetes mellitus.

Adiponectin is closely related to glucose metabolism and newly diagnosed type 2 diabetes mellitus (T2DM), and other kinds of diabetes linked to the risk of T2DM. Therefore, it is of interest to report the correlation between adiponectin levels and glycosylated hemoglobin (HbA1c) as a diagnostic marker of T2DM and healthy control. Total 210 participants were included of IPD & OPD healthy controls with glycosylated hemoglobin levels under 6% were included. Blood samples, collected using sterile clot activator or plain vials, were stored at -20°C. The biomarker score that comprised significant differences in age, gender distribution, and metabolic indicators are seen between the diabetes (n=105) and control (n=105) groups. Increase in both Adiponectin and HbA1c% Mean±SD (6.86±0.23, p<0.0001; 22.71±2.01; p<0.0001) is indicative of deteriorating glycaemic control and an accompanying rise in inflammatory response. Positively correlate adiponectin levels with HbA1c levels (r2=0.398; p<0.0001), suggesting a link between inflammatory response and glucose control. Lower adiponectin levels are statistically associated with diabetes. Diabetes and adiponectin were negatively correlated and positive linear relationship between HbA1c and adiponectin levels. Adiponectin may be a significant factor useful in understanding the pathophysiology; they are likely to be straight forward instruments for predicting future risk of diabetes.

Associations of body mass index trajectory, waist circumference trajectory, or both with type 2 diabetes mellitus risk in Chinese adults: The China-PAR project.

To identify the trajectories of body mass index (BMI) and waist circumference (WC), and assess the associations of BMI trajectory, WC trajectory, or the two combined, with type 2 diabetes mellitus (T2DM) risk in Chinese adults. This study was based on a prospective project-the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). A total of 54 434 participants (39.21% men) who were measured on at least two occasions were included. Three slowly increasing trajectory patterns were identified for BMI, and four for WC, by latent mixed modelling. A nine-category variable was derived by combining the WC trajectory (low, moderate, moderate-high/high) and the BMI trajectory (low, moderate, high). Logistic regression models were applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The risk of developing T2DM increased with elevated BMI or WC trajectory levels (all ptrend <0.001). The risks were 2.85 (2.59-3.14) for high BMI trajectory and 4.34 (3.78-4.99) for high WC trajectory versus low trajectory groups, respectively. The association was more pronounced among younger individuals (pinteraction <0.001). In the joint analysis, compared to participants with low WC and BMI trajectory, those with moderate-high/high WC combined with high BMI trajectory had the highest risk of T2DM (OR 3.96, 95% CI 3.48-4.50); even those who maintained moderate-high/high WC but low BMI trajectory showed a higher T2DM risk (OR 3.00, 95% CI 2.31-3.91). This study suggests that simultaneous dynamic and continuous monitoring of BMI and WC may contribute more than single measurements to predicting T2DM risk and determining preventive strategies.

The risk of type 2 diabetes mellitus in multiple sclerosis and neuromyelitis optica spectrum disorder: A nationwide cohort study

Background and objectivesAn association has been suggested between premorbid type 2 diabetes mellitus (T2DM) and the risk of multiple sclerosis (MS). However, little is known about the risk of developing T2DM in MS and neuromyelitis optica spectrum disorder (NMOSD). This study aimed to determine the T2DM risk in patients with MS and NMSOD. MethodsThe Korean National Health Insurance Service database was analyzed, and 1,801 and 1,721 adults with MS and NMOSD, respectively, who were free of T2DM between January 2010 and December 2017, were included. Matched controls were selected based on age, sex, and the presence of hypertension and dyslipidemia. ResultsThe risk of developing T2DM was 1.54 times higher in NMOSD than in the controls (adjusted hazard ratio [aHR], 95 % confidence interval [CI] = 1.20–1.96). However, increased T2DM risk was not observed in MS (aHR = 1.13, 95 % CI = 0.91–1.42). The T2DM risk in patients with NMOSD was higher in those who received steroid treatment (aHR = 1.77, 95 % CI = 1.36–2.30) but not in those who did not (aHR = 0.59, 95 % CI = 0.24–1.43, p for interaction = 0.02). DiscussionT2DM risk was increased in NMOSD but not in MS. Administering steroid treatment to patients with NMOSD may increase their T2DM risk.

Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus: dual evidence from NHANES database and Mendelian randomization analysis.

Low levels of high-density lipoprotein cholesterol (HDL-C) are commonly seen in patients with type 2 diabetes mellitus (T2DM). However, it is unclear whether there is an independent or causal link between HDL-C levels and T2DM. This study aims to address this gap by using the The National Health and Nutrition Examination Survey (NHANES) database and Mendelian randomization (MR) analysis. Data from the NHANES survey (2007-2018) with 9,420 participants were analyzed using specialized software. Logistic regression models and restricted cubic splines (RCS) were used to assess the relationship between HDL-C and T2DM incidence, while considering covariates. Genetic variants associated with HDL-C and T2DM were obtained from genome-wide association studies (GWAS), and Mendelian randomization (MR) was used to evaluate the causal relationship between HDL-C and T2DM. Various tests were conducted to assess pleiotropy and outliers. In the NHANES study, all groups, except the lowest quartile (Q1: 0.28-1.09 mmol/L], showed a significant association between HDL-C levels and reduced T2DM risk (all P < 0.001). After adjusting for covariates, the Q2 [odds ratio (OR) = 0.67, 95% confidence interval (CI): (0.57, 0.79)], Q3 [OR = 0.51, 95% CI: (0.40, 0.65)], and Q4 [OR = 0.29, 95% CI: (0.23, 0.36)] groups exhibited average reductions in T2DM risk of 23%, 49%, and 71%, respectively. In the sensitivity analysis incorporating other lipid levels, the Q4 group still demonstrates a 57% reduction in the risk of T2DM. The impact of HDL-C levels on T2DM varied with age (P for interaction = 0.006). RCS analysis showed a nonlinear decreasing trend in T2DM risk with increasing HDL-C levels (P = 0.003). In the MR analysis, HDL-C levels were also associated with reduced T2DM risk (OR = 0.69, 95% CI = 0.52-0.82; P = 1.41 × 10-13), and there was no evidence of pleiotropy or outliers. This study provides evidence supporting a causal relationship between higher HDL-C levels and reduced T2DM risk. Further research is needed to explore interventions targeting HDL-C levels for reducing T2DM risk.

Genetic Variants of CYP2C8 Gene Predisposition to Type 2 Diabetes Risk

Background: Type 2 diabetes mellitus (T2DM) is characterized by elevated blood glucose levels due to insulin resistance or inadequate insulin secretion from pancreatic beta cells. The mitochondrial CYP2C8 gene, located on chromosome 10q24, encodes cytochrome P450 and spans 37 kb with nine exons. Genetic variants in this gene may influence T2DM susceptibility. Method: This study aimed to investigate the association between genetic polymorphisms in the CYP2C8 gene (rs1934953 and rs1934952) and the risk of T2DM in Iraqi patients. Blood samples were collected from 48 participants, including 24 T2DM patients and 24 healthy controls. DNA extraction, polymerase chain reaction (PCR), and sequencing were performed to analyze genetic variations. Statistical analysis was conducted using chi-square tests, logistic regression, and Hardy-Weinberg equilibrium calculations. Results: Analysis revealed that the rs1934953 variant in the CYP2C8 gene was associated with T2DM, with the A allele showing a protective effect (odds ratio: 0.840, 95% confidence interval: 0.780-0.904, P=3.04×10-6). Additionally, an interaction effect between rs1934953 in CYP2C9 and rs12766752 in CYP2C8 on T2DM risk was observed (P=0.003). Furthermore, rs1934953 showed significant association with high-density lipoprotein cholesterol (HDL-C). At the rs1934952 C/T locus, a transition type genetic mutation was detected, with the TT genotype considered a risk factor for T2DM, while the CC and CT genotypes were protective. The Hardy-Weinberg probability value for the patient group was 0.0321, indicating notable discrepancies in genotype distribution, while the healthy group showed no significant differences (Hardy probability: 0.2001). The TT genotype at rs1934953 was associated with a decreased risk of T2DM, while the CC and CT genotypes were potential risk factors. Conversely, at rs1934952, the CC and CT genotypes were protective against T2DM, while the TT genotype was associated with increased risk. Conclusion: in conclusion, the study indicates that there may be links between CYP2C8 gene variances and an increased chance of type 2 diabetes in Iraqi patients.

Investigation of the causal relationship between inflammatory bowel disease and type 2 diabetes mellitus: a Mendelian randomization study.

Background: Type 2 diabetes mellitus (T2DM) and inflammatory bowel disease (IBD) have been associated, according to various epidemiological research. This study uses Mendelian randomization (MR) to investigate the causal link between T2DM and IBD. Methods: To investigate the causal relationship between IBD and T2DM risk using European population data from the genome-wide association study (GWAS) summary datasets, we constructed a two-sample MR study to evaluate the genetically predicted impacts of liability towards IBD outcomes on T2DM risk. As instrumental variables (IVs), we chose 26 single nucleotide polymorphisms (SNPs) associated with IBD exposure data. The European T2DM GWAS data was obtained from the IEU OpenGWAS Project database, which contains 298,957 cases as the outcome data. The causal relationship between T2DM and IBD using a reverse MR analysis was also performed. Results: The two-sample MR analysis, with the Bonferroni adjustment for multiple testing, revealed that T2DM risk in Europeans is unaffected by their IBD liability (odds ratio (OR): 0.950-1.066, 95% confidence interval (CI): 0.885-1.019, p = 0.152-0.926). The effects of liability to T2DM on IBD were not supported by the reverse MR analysis either (OR: 0.739-1.131, 95% confidence interval (CI): 0.651-1.100, p = 0.058-0.832). MR analysis of IBS on T2DM also have no significant causal relationship (OR: 0.003-1.007, 95% confidence interval (CI): 1.013-5.791, p = 0.069-0.790). FUMA precisely mapped 22 protein-coding genes utilizing significant SNPs of T2DM acquired from GWAS. Conclusion: The MR study showed that the existing evidence did not support the significant causal effect of IBD on T2DM, nor did it support the causal impact of T2DM on IBD.

Association of plant-based dietary patterns with the risk of type 2 diabetes mellitus using cross-sectional results from RaNCD cohort

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in middle- and low-income countries, and this disease is a burden on public health systems. Notably, dietary components are crucial regulatory factors in T2DM. Plant-based dietary patterns and certain food groups, such as whole grains, legumes, nuts, vegetables, and fruits, are inversely correlated with diabetes incidence. We conducted the present study to determine the association between adherence to a plant-based diet and the risk of diabetes among adults. We conducted a cross-sectional, population-based RaNCD cohort study involving 3401 men and 3699 women. The plant-based diet index (PDI) was developed using a 118-item food frequency questionnaire (FFQ). Logistic regression models were used to evaluate the association between the PDI score and the risk of T2DM. A total of 7100 participants with a mean age of 45.96 ± 7.78 years were analysed. The mean PDI scores in the first, second, and third tertiles (T) were 47.13 ± 3.41, 54.44 ± 1.69, and 61.57 ± 3.24, respectively. A lower PDI was significantly correlated with a greater incidence of T2DM (T1 = 7.50%, T2 = 4.85%, T3 = 4.63%; P value < 0.001). Higher PDI scores were associated with significantly increased intakes of fibre, vegetables, fruits, olives, olive oil, legumes, soy products, tea/coffee, whole grains, nuts, vitamin E, vitamin C, and omega-6 fatty acids (P value < 0.001). After adjusting for confounding variables, the odds of having T2DM were significantly lower (by 30%) at T3 of the PDI than at T1 (OR = 0.70; 95% CI = 0.51, 0.96; P value < 0.001). Our data suggest that adhering to plant-based diets comprising whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea/coffee can be recommended today to reduce the risk of T2DM.

Association between pregnancy-related complications and development of type 2 diabetes and hypertension in women: an umbrella review

BackgroundDespite many systematic reviews and meta-analyses examining the associations of pregnancy complications with risk of type 2 diabetes mellitus (T2DM) and hypertension, previous umbrella reviews have only examined a single pregnancy complication. Here we have synthesised evidence from systematic reviews and meta-analyses on the associations of a wide range of pregnancy-related complications with risk of developing T2DM and hypertension.MethodsMedline, Embase and Cochrane Database of Systematic Reviews were searched from inception until 26 September 2022 for systematic reviews and meta-analysis examining the association between pregnancy complications and risk of T2DM and hypertension. Screening of articles, data extraction and quality appraisal (AMSTAR2) were conducted independently by two reviewers using Covidence software. Data were extracted for studies that examined the risk of T2DM and hypertension in pregnant women with the pregnancy complication compared to pregnant women without the pregnancy complication. Summary estimates of each review were presented using tables, forest plots and narrative synthesis and reported following Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines.ResultsTen systematic reviews were included. Two pregnancy complications were identified. Gestational diabetes mellitus (GDM): One review showed GDM was associated with a 10-fold higher risk of T2DM at least 1 year after pregnancy (relative risk (RR) 9.51 (95% confidence interval (CI) 7.14 to 12.67) and although the association differed by ethnicity (white: RR 16.28 (95% CI 15.01 to 17.66), non-white: RR 10.38 (95% CI 4.61 to 23.39), mixed: RR 8.31 (95% CI 5.44 to 12.69)), the between subgroups difference were not statistically significant at 5% significance level. Another review showed GDM was associated with higher mean blood pressure at least 3 months postpartum (mean difference in systolic blood pressure: 2.57 (95% CI 1.74 to 3.40) mmHg and mean difference in diastolic blood pressure: 1.89 (95% CI 1.32 to 2.46) mmHg). Hypertensive disorders of pregnancy (HDP): Three reviews showed women with a history of HDP were 3 to 6 times more likely to develop hypertension at least 6 weeks after pregnancy compared to women without HDP (meta-analysis with largest number of studies: odds ratio (OR) 4.33 (3.51 to 5.33)) and one review reported a higher rate of T2DM after HDP (hazard ratio (HR) 2.24 (1.95 to 2.58)) at least a year after pregnancy. One of the three reviews and five other reviews reported women with a history of preeclampsia were 3 to 7 times more likely to develop hypertension at least 6 weeks postpartum (meta-analysis with the largest number of studies: OR 3.90 (3.16 to 4.82) with one of these reviews reporting the association was greatest in women from Asia (Asia: OR 7.54 (95% CI 2.49 to 22.81), Europe: OR 2.19 (95% CI 0.30 to 16.02), North and South America: OR 3.32 (95% CI 1.26 to 8.74)).ConclusionsGDM and HDP are associated with a greater risk of developing T2DM and hypertension. Common confounders adjusted for across the included studies in the reviews were maternal age, body mass index (BMI), socioeconomic status, smoking status, pre-pregnancy and current BMI, parity, family history of T2DM or cardiovascular disease, ethnicity, and time of delivery. Further research is needed to evaluate the value of embedding these pregnancy complications as part of assessment for future risk of T2DM and chronic hypertension.

The combination of body mass index and fasting plasma glucose is associated with type 2 diabetes mellitus in Japan: a secondary retrospective analysis.

Body mass index (BMI) and fasting plasma glucose (FPG) are known risk factors for type 2 diabetes mellitus (T2DM), but data on the prospective association of the combination of BMI and FPG with T2DM are limited. This study sought to characterize the association of the combination of BMI and FPG (ByG) with T2DM. The current study used the NAGALA database. We categorized participants by tertiles of ByG. The association of ByG with T2DM was expressed with hazard ratios (HRs) with 95% confidence intervals (CIs) after adjustment for potential risk factors. During a median follow-up of 6.19 years in the normoglycemia cohort and 5.58 years in the prediabetes cohort, the incidence of T2DM was 0.75% and 7.79%, respectively. Following multivariable adjustments, there were stepwise increases in T2DM with increasing tertiles of ByG. After a similar multivariable adjustment, the risk of T2DM was 2.57 (95% CI 2.26 - 2.92), 1.97 (95% CI 1.53 - 2.54) and 1.50 (95% CI 1.30 - 1.74) for a per-SD change in ByG in all populations, the normoglycemia cohort and the prediabetes cohort, respectively. ByG was associated with an increased risk of T2DM in Japan. The result reinforced the importance of the combination of BMI and FPG in assessing T2DM risk.

Screen time in the development of type 2 diabetes mellitus (T2DM) : a two-sample Mendelian randomization study.

This study aimed to investigate the potential causal relationship between screen time and the risk of developing type 2 diabetes mellitus (T2DM) using Mendelian randomization. Two-sample Mendelian randomization was conducted, utilizing genetic variants associated with different types of screen time as instrumental variables. Single nucleotide polymorphisms (SNPs) were used to assess the primary outcome, which was the risk of developing T2DM. The analysis revealed a significant positive causal association between television viewing time and the risk of T2DM. Specifically, excessive television viewing time was found to increase the risk of developing T2DM (OR: 2.39, 95% CI: 1.90 to 3.00, P < 0.01). However, no significant causal relationship was observed between computer usage time and the risk of T2DM. Additionally, mobile phone use time showed a positive correlation with the risk of T2DM (OR: 1.31, 95% CI: 1.04 to 1.64, P = 0.02), albeit to a lesser extent than television viewing time. The findings of this study indicate a significant causal association between certain types of screen time, specifically television viewing and mobile phone use, and an increased risk of T2DM.

Fetal loss and long-term maternal morbidity and mortality: A systematic review and meta-analysis.

Evidence suggests common pathways between pregnancy losses and subsequent long-term maternal morbidity, rendering pregnancy complications an early chronic disease marker. There is a plethora of studies exploring associations between miscarriage and stillbirth with long-term adverse maternal health; however, these data are inconclusive. We systematically searched MEDLINE, EMBASE, AMED, BNI, CINAHL, and the Cochrane Library with relevant keywords and MeSH terms from inception to June 2023 (no language restrictions). We included studies exploring associations between stillbirth or miscarriage and incidence of cardiovascular, malignancy, mental health, other morbidities, and all-cause mortality in women without previous pregnancy loss. Studies reporting short-term morbidity (within a year of loss), case reports, letters, and animal studies were excluded. Study selection and data extraction were performed by 2 independent reviewers. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS) and publication bias with funnel plots. Subgroup analysis explored the effect of recurrent losses on adverse outcomes. Statistical analysis was performed using an inverse variance random effects model and results are reported as risk ratios (RRs) with 95% confidence intervals (CIs) and prediction intervals (PIs) by combining the most adjusted RR, odds ratios (ORs) and hazard ratios (HRs) under the rare outcome assumption. We included 56 observational studies, including 45 in meta-analysis. There were 1,119,815 women who experienced pregnancy loss of whom 951,258 had a miscarriage and 168,557 stillbirth, compared with 11,965,574 women without previous loss. Women with a history of stillbirth had a greater risk of ischaemic heart disease (IHD) RR 1.56, 95% CI [1.30, 1.88]; p < 0.001, 95% PI [0.49 to 5.15]), cerebrovascular (RR 1.71, 95% CI [1.44, 2.03], p < 0.001, 95% PI [1.92, 2.42]), and any circulatory/cardiovascular disease (RR 1.86, 95% CI [1.01, 3.45], p = 0.05, 95% PI [0.74, 4.10]) compared with women without pregnancy loss. There was no evidence of increased risk of cardiovascular disease (IHD: RR 1.11, 95% CI [0.98, 1.27], 95% PI [0.46, 2.76] or cerebrovascular: RR 1.01, 95% CI [0.85, 1.21]) in women experiencing a miscarriage. Only women with a previous stillbirth were more likely to develop type 2 diabetes mellitus (T2DM) (RR: 1.16, 95% CI [1.07 to 2.26]; p < 0.001, 95% PI [1.05, 1.35]). Women with a stillbirth history had an increased risk of developing renal morbidities (RR 1.97, 95% CI [1.51, 2.57], p < 0.001, 95% [1.06, 4.72]) compared with controls. Women with a history of stillbirth had lower risk of breast cancer (RR: 0.80, 95% CI [0.67, 0.96], p-0.02, 95% PI [0.72, 0.93]). There was no evidence of altered risk of other malignancies in women experiencing pregnancy loss compared to controls. There was no evidence of long-term mental illness risk in women with previous pregnancy losses (stillbirth: RR 1.90, 95% CI [0.93, 3.88], 95% PI [0.34, 9.51], miscarriage: RR 1.78, 95% CI [0.88, 3.63], 95% PI [1.13, 4.16]). The main limitations include the potential for confounding due to use of aggregated data with variable degrees of adjustment. Our results suggest that women with a history of stillbirth have a greater risk of future cardiovascular disease, T2DM, and renal morbidities. Women experiencing miscarriages, single or multiple, do not seem to have an altered risk.

Normal triglyceride concentration and the risk of diabetes mellitus type 2 in the general population of China.

Hypertriglyceridemia and its derivatives are independent predictors of diabetes mellitus type 2 (T2DM). However, the relationship between triglyceride concentrations within the normal range and the incidence of T2DM remains to be clarified. This study investigated the potential relationship between variations in plasma triglyceride levels within the normal range and T2DM onset using data from a longitudinal study of health and retirement in China. Between, 2010 and, 2016, we conducted a retrospective cohort study involving 36,441 individuals with normal triglyceride levels. Using a Cox proportional hazards regression model, we examined the connection between normal triglyceride levels and T2DM incidence. We employed this method with smooth curve fitting to investigate potential nonlinear associations. Subgroup analyses were performed based on age, sex, body mass index, smoking and drinking status, hypertension, and family history of diabetes. A significant linear relationship was observed between normal triglyceride levels and the incidence of T2DM. The hazard ratio for T2DM in individuals with normal triglycerides was 1.81 (95% confidence interval: 1.39, 2.36); P<0.001). Kaplan-Meier analysis further demonstrated a prospective association between the higher tertiles of normal triglyceride levels and the development of T2DM (P<0.001). Subgroup analysis revealed a stronger positive correlation between normal triglyceride levels in females and the risk of T2DM. An increase in triglyceride levels within the normal range is related to a continuous increase in the incidence of T2DM in the general population. These findings show that almost everyone can benefit from reducing triglyceride levels, further emphasizing the importance of lifestyle changes in the general population.

Treat Obesity to Treat Type 2 Diabetes Mellitus.

Obesity, a multifactorial, relapsing chronic disease, serves as a gateway to a spectrum of metabolic, cardiovascular, mechanical and mental health problems. Over the last few decades, the global prevalence of obesity has surged nearly threefold, mirroring the escalating rates of type 2 diabetes mellitus (T2DM). This parallel trajectory strongly suggests a cause-and-effect relationship between obesity and T2DM. Extensive research indicates that even modest weight gain elevates the risk of T2DM, favoring the notion of obesity being a root cause. This perspective finds robust support in numerous studies demonstrating the preventive effects of obesity management on the onset of T2DM. Beyond prevention, obesity management has been shown to enhance remission in individuals with T2DM and to decrease microvascular complications, cardiovascular risk factors, renal failure and heart failure. This evidence underpins the urgent need for global initiatives aimed at addressing obesity management as a key strategy in the prevention and management of T2DM and its complications.