Fasting Serum Triglyceride Research Articles

Association of Insulin Receptor Substrate-1 Gly972Arg Polymorphism with Dyslipidemia in Iraqi Type 2 Diabetic patients: A case-control Study

Background: Diabetic dyslipidemia is a primary contributor to mortality from coronary artery disease (CAD). It is prevalent in diabetic patients and manifests as an elevation of triglyceride (TG) alongside reduced high-density lipoprotein (HDL) concentrations. Both genetic and environmental factors influence the onset of dyslipidemia in type 2 diabetes mellitus (T2DM). The current study aimed to evaluate the involvement of the IRS-1 Gly 972 Arg gene polymorphism in the development of dyslipidemia in type 2 Iraqi diabetics Methods: Two hundred type 2 Iraqi diabetics were recruited, 105 patients with dyslipidemia and 95 without. The IRS-1 gene was analyzed for Gly 972 Arg single nucleotide polymorphism (SNP) by PCR-RFLP. Results: The codominant models explored a significant (OR = 4.4, CI 95% = 1.4 – 13.9, P = 0.01) increase of carriers of the GA genotype in the group of diabetics with dyslipidemia compared to those without. The dominant models highlighted a significant (OR = 4.7, P = 0.008, CI 95% = 1.5 – 14.8) rise of carriers of the variant allele in the group of diabetics with dyslipidemia when compared with those of diabetic patients without. The distribution of the investigated phenotypes was analyzed in relevance to the genotypes of the dominant model (GA + AA vs GG). There were significant (P = 0.01 – 0.006) elevations of fasting serum glucose (FSG), glycosylated haemoglobin (HbA1c), TC, TG, very-low-density lipoprotein (VLDL), and low-density lipoprotein (LDL), concentrations in carriers of the GA+ AA genotypes when compared with those of the GG genotypes. However, IRS-1 concentration was significantly (P = 0.04) decreased in the group of GA+AA carriers compared to those of the GG carriers. Conclusions: Type 2 Iraqi diabetics who carry the variant allele of the rs1801278 SNP of the IRS1 gene are fourfold more susceptible to dyslipidemia compared to those who have the wild allele. Moreover, metabolic changes are relevant to the analyzed SNP.

Epicardial Fat Volume Assessed by MRI in Adolescents: Associations with Obesity and Cardiovascular Risk Factors.

Background: In adults, epicardial adipose tissue (EAT) is associated with metabolic syndrome (MS) and coronary artery disease. EAT thickness is increased in obese youth, but total EAT volume and its correlation with cardiovascular risk factors have not been studied. Objectives: To determine EAT volume in adolescents and its association with obesity and cardiovascular risk factors. Methods: We performed a cross-sectional study including 48 pubertal adolescents (24 obese and 24 lean subjects, aged 13.6 ± 1.5 yr). EAT volume as well as visceral and subcutaneous abdominal adipose tissue volumes were obtained by magnetic resonance imaging. Anthropometrical parameters; blood pressure (BP); fasting serum triglycerides; total and low- and high-density lipoprotein (HDL-C) cholesterol; glucose; and insulin levels were measured. Results: Obese adolescents had higher EAT volume compared to lean controls (49.6 ± 18.0 vs. 17.6 ± 6.7 cm3, p < 0.0005). They also had significantly increased visceral abdominal fat volumes, systolic BP, serum triglycerides, and insulin levels, and decreased HDL-C concentration. EAT volume was significantly associated with anthropometrical indices and cardiovascular risk factors: waist circumference, systolic BP, triglycerides, HDL-C levels, and insulin resistance indices. Metabolic syndrome was present in 25% of obese adolescents. EAT volume was significantly higher in obese adolescents with MS compared to those without MS (63.5 ± 21.4 vs. 44.9 ± 14.6 cm3, p = 0.026). Conclusions: EAT volume, which is known to contribute to atherogenesis in adults, is increased in obese adolescents, and is associated with abdominal visceral fat, cardiovascular risk factors, and MS. Excessive EAT early in life may contribute to the development of premature cardiometabolic disease.

Causal associations of Helicobacter pylori infection and metabolic syndrome: insights from a two-sample Mendelian randomization study

BackgroundHelicobacter pylori (Hp) infection and metabolic syndrome (MetS) have a high prevalence of co-morbidities and both pose a significant threat to human health and survival. It has been suggested that Hp infection affects the development of MetS in the host, but the causal relationship between the two has not been confirmed.MethodsWe conducted a two-sample Mendelian randomization study to investigate the causal effect of Hp infection with MetS and its components. Summary statistics for exposure factors (Hp infection) were obtained from the GWAS Catalog (anti-Hp IgG, n = 8,735; Hp VacA antibody levels, n = 1,571; Hp GroEL antibody levels, n = 2,716; Hp OMP antibody levels, n = 2,640). Summary statistics for outcome factors (MetS) were obtained from the most comprehensive genome-wide association study (GWAS) currently available (n = 291,107) as well as from the components of MetS: fasting glucose (n = 46,186), hypertension (n = 461,880), serum triglycerides (n = 115,082), waist circumference (n = 21,949), and high-density lipoprotein (n = 400, 754). The inverse-variance weighted (IVW) method was used as the primary MR method and the robustness of the results was assessed through sensitivity analyses.ResultsMR analysis showed that anti-Hp IgG levels were positively correlated with waist circumference (β = 0.08, P = 0.012), and GroEL antibody levels showed an opposite correlation with HDL levels (β= -0.03, P = 0.025) and TG (β = 0.02, P = 0.045). In contrast, OMP antibodies levels were positively correlated with both HDL and FBG (β = 0.064, P = 0.037 and β = 0.09, P = 0.003). In the estimation of IVW as the main causal method, VacA antibody level was positively associated with hypertension level and negatively associated with TG (β = 0.02, P = 0.008 and β= -0.02, P = 0.007). Meanwhile, the results of sensitivity analyses showed no heterogeneity or significant level pleiotropy.ConclusionsOur study suggests that there is a causal effect between Hp infection and Mets diagnosis and its composition, and further studies are needed to understand the mechanism of its influence.

The Occurrence of Metabolic Syndrome In Patients With Psoriasis

Objective: To determine occurrence of metabolic syndrome in patients of Psoriasis and to highlight any gender-based differences. Study Design: Cross-sectional study design. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi. Our research was conducted from July to December 2020 (6 months). Patients and Methods: A total of 80 patients diagnosed with psoriasis were selected using non-probability consecutive sampling. Informed written consent was obtained from each patient and a questionnaire was filled. Variables such as blood pressure, waist circumference, body surface area covered by psoriasis, and Psoriasis Area Severity Index were recorded on initial visit. Fasting blood sugar, serum triglyceride and HDL cholesterol levels were advised. Patients were diagnosed to have metabolic syndrome if 3 or more of the 5 criteria for the modified version of the National Cholesterol Education Program Adult Panel III were met. Results: There were 62 male &amp; 18 female patients. A total of 39 patients (48.8%) met the criteria for metabolic syndrome. Amongst these, 26/62(41.9%) males &amp; 13/18(72.2%) females fulfilled the criteria. The mean BMI of males was 26.0 and those of females was 28.3 &amp; their comparison demonstrated a noteworthy difference (p=0.04). A statistically significant (p=0.038) positive correlation (r) of 0.233 was observed between body surface area and BMI. Conclusion: Metabolic syndrome is seen frequently in patients of Psoriasis. Female patients have a significant frequency of metabolic syndrome and tend to have a higher BMI than males.

Effectiveness of Internet + E-Coach chronic disease management on blood glucose, lipid levels, liver function, and quality of life in patients with chronic diabetic retinopathy: a comparative study

ObjectiveThis study aims to explore the effect of Internet + E-Coach chronic disease system intervention on fasting blood glucose (FPG), 2-hour postprandial blood glucose(2hPG), fasting serum insulin (FINS), triglyceride (TG), alanine transaminase (ALT) and quality of life in patients with chronic diabetic retinopathy.Methods208 patients with chronic diabetic retinopathy who were treated in the hospital from March 2021 to March 2023 are chosen and separated into two groups by random number Table 104 patients in the control group received routine continuous intervention, and the research group received Internet + E-Coach chronic disease system intervention. The cognition of disease related knowledge, blood related indicators inflammatory factor levels and improvement of life quality between the two groups before intervention, 6 and 12 months after intervention were compared.ResultsBefore the intervention, the comparison between the two groups in disease related knowledge scores, blood glucose, blood lipid, liver function indicators, inflammatory factor, and low vision quality of life scale (CLVQOL) scores was with P > 0.05. After 6 and 12 months of intervention, the research group had significantly higher scores for basic blood glucose intervention, healthy diet, reasonable exercise, and correct medication use compared to the control group (P < 0.05). FPG, 2hPG, TG and ALT in the research group were lower than those in the control group. FINS were higher in the control group, with P < 0.05. Interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and hypersensitive C-reactive protein (Hs-CRP) in the research group were obviously lower than those in the control group (P < 0.05). The scores of far vision, movement and light perception, adjustment ability, reading and fine work, and daily living ability in the research group were higher than those in the control group, with P < 0.05.ConclusionThe intervention of Internet + E-Coach chronic disease system can improve the knowledge of chronic diabetic retinopathy patients about their own condition, stabilize the levels of blood sugar, blood lipid and liver function indicators, reduce the inflammatory reaction of the body, and improve the quality of life.

8077 Use of Lovaza for Management of Hypertriglyceridemia in Pregnancy

Abstract Disclosure: J. Segarra-Villafane: None. L.R. Sepulveda-Garcia: None. L. El Musa Penna: None. I.C. Arroyo: None. Z. Maisonet -Feliciano: None. W. Medina-Torres: None. M. Alvarado: None. M. Ramirez: None. L.A. Gonzalez-Rodriguez: None. Severe hypertriglyceridemia in pregnancy increases the risk of health complications to both mother and fetus, including preeclampsia, hyperviscosity syndrome and life-threatening pancreatitis. Several case reports include management of hypertriglyceridemia in pregnancy with medical nutrition therapy, omega fatty acids and gemfibrozil but is controversial. There are no formal clinical guidelines for management of severe hypertriglyceridemia in pregnancy which presents a challenge for physicians. Lovaza is a combination of ethyl esters of omega 3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) indicated as an adjunct to diet to reduce triglycerides (TG) levels in adult patients with severe hypertriglyceridemia. Lovaza is Category C (risk cannot be ruled out) and should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Case of a 40 years old female G3P1A1 with IUP 25 WGA with history of hypothyroidism, dyslipidemia and episode of acute pancreatitis in 2016 due to hypertriglyceridemia, who was referred to clinics due to uncontrolled lipids and thyroid disease. Laboratories included fasting serum triglycerides (TG) 4357mg/dL (40-150mg/dL), total cholesterol 525mg/dL (120-200), HDL 56mg/dL, LDL invalid due to elevated TG. Thyroid function test revealed TSH of 161uIU/mL (0.43-2.91) and FT4 of 0.24ng/dL (0.8-1.8). HbA1c, lipase and amylase within range. Vital signs were normal. Patient was asymptomatic, no abdominal complaints or hypothyroidism-related symptoms, but hospital admission was recommended due to high risk of pancreatitis and uncontrolled hypothyroidism. She was started on Synthroid 220 mcg IV daily for hypothyroidism and was placed NPO until nutritionist evaluation. Triglycerides levels improved with conservative interventions and low-fat diet. However, TG persisted above 2000mg/dL and, after discussing risks and benefits with patient, pharmacological therapy with Lovaza was started to reach goal of TG less than 1000 mg/dL and reduce potential risk of pancreatitis. Patient agreed to start Lovaza 2gm AM and 2gm PM. After initiation of Lovaza, in addition to dietary modifications and hypothyroidism management, laboratories showed significant improvement in TG levels from 3569 down to 1778 mg/dL. Patient was discharged on Lovaza 2gm oral BID and Synthroid 200mcg oral daily. One month later, TG had decreased to 557mg/dL (0-150) and thyroid tests showed TSH at 0.305mIU/mL and FT4 at 1.71ng/dL. Patient tolerated medications well without side effects and had an uncomplicated pregnancy and delivery. This case demonstrates that severe hypertriglyceridemia during pregnancy can be managed effectively and, more importantly, in a safe manner with Lovaza, in addition to dietary fat restriction. However, additional research is needed if its use is to be included in future pregnancy management guidelines. Presentation: 6/2/2024

Efficacy and safety of olezarsen in lowering apolipoprotein C-III and triglycerides in healthy Japanese Americans

BackgroundOlezarsen is a GalNAc3-conjugated, hepatic-targeted antisense oligonucleotide that lowers apolipoprotein C-III (apoC-III) and triglyceride levels. The efficacy and safety of olezarsen has not previously been studied in ethnically diverse American populations. The aim of this study is to assess the effect of olezarsen in healthy Japanese Americans.MethodsA randomized, placebo-controlled, double-blind phase 1 study was performed in 28 healthy Japanese American participants treated with olezarsen in single-ascending doses (SAD; 30, 60, 90 mg) or multiple doses (MD; 60 mg every 4 weeks for 4 doses). The primary, secondary, and exploratory objectives were safety and tolerability, pharmacokinetics, and effects of olezarsen on fasting serum triglycerides and apoC-III, respectively.ResultsThere were 20 participants (16 active:4 placebo) in the SAD part of the study, and 8 participants (6 active:2 placebo) in the MD part of the study. For the primary endpoint, no serious adverse events or clinically relevant laboratory abnormalities were reported. The majority of olezarsen plasma exposure occurred within 24 h post-dose. In the SAD cohorts at Day 15 the percentage reduction in apoC-III/TG was − 39.4%/ − 17.8%, − 60.8%/ − 52.7%, and − 68.1%/ − 39.2% in the 30, 60 and 90 mg doses, respectively, vs 2.3%/44.5% increases in placebo. In the MD cohort, at Day 92 the percentage reduction in apoC-III/TG was − 81.6/ − 73.8% vs − 17.2/ − 40.8% reduction in placebo. Favorable changes were also present in VLDL-C, apoB and HDL-C.ConclusionsSingle- and multiple-dose administration of olezarsen was safe, was well tolerated, and significantly reduced apoC-III and triglyceride levels in healthy Japanese Americans.

Are the EAT-Lancet dietary recommendations associated with future cardiometabolic health? – Insights from the Generation XXI cohort from childhood into early adolescence

BackgroundThe prospective effect of healthy and planetary diets on cardiometabolic health at young ages remains unclear. ObjectivesThis study aims to investigate the prospective associations between adherence to the EAT-Lancet dietary recommendations at age 7 and the prevalence of obesity and Metabolic Syndrome (MetS) at 7, 10, and 13 y old. MethodsParticipants are children from the Generation XXI birth cohort who completed 3-d food diaries at age 7, with complete data in variables of interest (n = 3564). Adherence to the EAT-Lancet dietary recommendations was evaluated using the World Index for Sustainability and Health (WISH); a higher score indicates a healthier and environmentally sustainable diet. At 7, 10, and 13 y, anthropometrics (weight, height, and waist circumference), blood pressure, serum-fasting triglycerides, high-density lipoprotein cholesterol, and glucose were measured. Obesity and MetS prevalence were determined by the World Health Organization and the International Diabetes Federation criteria, respectively. Adjusted custom binomial log-linear models were used to calculate prevalence ratios (PR) and the respective 95% confidence intervals (95% CI) (covariates: mother’s age, education, prepregnancy body mass index (BMI), gestational diabetes, child’s sex, age, Tanner stage, sports practice and total grams of the remaining food). ResultsFrom 7 to 13 y, obesity decreased from 14.1% to 9.3% and MetS increased from 1.0% to 5.1%. Higher WISH scores at 7 y were associated with a lower prevalence of obesity, measured by both BMI (≥97th percentile: PR = 0.912; 95% CI: 0.839, 0.991; PR = 0.882; 95% CI: 0.79, 0.938, respectively at 10 and 13 y) and waist circumference (≥90th percentile: PR = 0.899; 95% CI: 0.830, 0.974; PR = 0.858; 95% CI: 0.782, 0.942, respectively at 10 and 13 y). For each 10-point increase in the WISH, a reduction of 16% in MetS prevalence at 13 y was observed (PR = 0.837; 95% CI: 0.732, 0.957). No significant effects were found at younger ages. ConclusionsAdherence to the EAT-Lancet diet from an early age may help reduce cardiometabolic risk in early adolescence.

Fasting hypertriglyceridemia in relation to mortality in an elderly male Chinese population.

We investigated fasting hypertriglyceridemia as predictors of all-cause, cardiovascular, and non-cardiovascular mortality in an elderly male Chinese population, while accounting for various conventional cardiovascular risk factors. Our participants were elderly men recruited from residents living in a suburban town of Shanghai (≥60 years of age, n=1583). Hypertriglyceridemia was defined as a fasting serum triglycerides concentration ≥1.70mmol/L. Subgroup analyses were performed according to current smoking (yes vs. no), alcohol intake (yes vs. no), and the presence and absence of hypertension and hyperglycemia. During a median of 7.9 years follow-up, all-cause, cardiovascular, and non-cardiovascular deaths occurred in 279, 112, and 167 participants, respectively. After adjustment for confounding factors, fasting hypertriglyceridemia was not significantly (p ≥.33) associated with the risk of all-cause, cardiovascular, and non-cardiovascular mortality. However, there was significant (p=.03) interaction between hypertriglyceridemia and the presence and absence of hypertension in relation to all-cause mortality. In normotensive, but not hypertensive individuals, hypertriglyceridemia was significantly associated with a higher risk of all-cause mortality (hazard ratio 1.57, 95% confidence interval 1.06-2.31). In further non-parametric analyses in normotensive individuals, the age-standardized rate for all-cause mortality increased from 18.9 in quartile 1 to 20.0, to 24.7, and to 39.9 per 1000 person-years in quartiles 2, 3, and 4 of serum triglycerides concentration, respectively (ptrend=.0004). Similar results were observed for cardiovascular mortality. Our study in elderly male Chinese showed that fasting hypertriglyceridemia was associated with a higher risk of all-cause and cardiovascular mortality in patients with normotension but not those with hypertension.

Evaluation of Fasting Glucose-Insulin-C-Peptide-Derived Metabolic Indices for Identifying Metabolic Syndrome in Young, Healthy Adults.

Metabolic syndrome (MetS) is a condition defined by a cluster of symptoms, including excessive adipose tissue, impaired glucose homeostasis, dyslipidemia, and high blood pressure (BP). We aimed to evaluate the correlation between the MetS criteria (IDF) and fasting glucose-insulin-C-peptide-derived indices in a cohort of 128 healthy young adults who were 20-35 years old at the time of this study. We measured fasting serum glucose, insulin, C-peptide (CP), HDL-cholesterol, triglycerides, and hsCRP; HOMA-IR INS, HOMA-IR CP1, HOMA-IR CP2, HOMA-BETA, HOMA-BETA CP, QUICKI, disposition index (DI), CP index (CPI), and 20/C-peptide*glucose. Significant correlations were found between BMI and all HOMA indices, QUICKI, and CPI; waist circumferences and HOMA-IR INS, HOMA-BETA, and QUICKI (for both sexes); glucose and HOMA-IR INS/CP1/CP2, HOMA-BETA CP, DI, and QUICKI; HDL-cholesterol and HOMA-IR INS, HOMA-BETA, and QUICKI for males and females only with QUICKI; triglycerides and HOMA-IR INS, HOMA-BETA, and QUICKI; systolic BP and HOMA-IR INS, HOMA-BETA; diastolic BP and DI. The cut-off values for HOMA-IR INS, HOMA-BETA, and QUICKI in the combined group (females + males) were 1.855, 82.250, 0.355; 2.115, 106.370, 0.345 for males; 1.805, 71.305, 0.355 for females. A stronger correlation was found between males' indices and hsCRP. In conclusion, CP-derived indices do not add significant information, and the male sex is more predisposed to MetS.

Low serum adiponectin levels are associated with an increased risk of diabetes in obese dogs.

Adiponectin plays an important role in carbohydrate and lipid metabolism. However, the evidence regarding the association between adiponectin and diabetes mellitus in obese dogs is sparse. The aim of this study is to investigate the associations of adiponectin with the risk of diabetes mellitus in obese dogs on the basis of a prospective cohort study. Serum adiponectin levels in obese dogs recruited from three small animal hospitals between 2015 and 2018 were measured by ELISA. Electronic health records were used to record the incidence of diabetes mellitus during follow-up for 3 years. A total of 862 dogs were included. Amongst the 862 dogs, 51 developed diabetes. Adiponectin levels were associated with diabetes mellitus after adjusting for sex, age, breed, exercise, body condition score, fasting plasma glucose, serum triglyceride and total cholesterol. When adjusting for sex, age, breed, exercise, body condition score, fasting plasma glucose, serum triglyceride and total cholesterol, the adjusted hazard ratios were 7.83 (95% confidence interval: 2.67 to 30.13) in the lowest adiponectin group and 1.96 (95% CI: 1.10 to 8.55) in the medium adiponectin group relative to that in the highest adiponectin group. The area under a curve of adiponectin's Receiver operating characteristic curve was 0.81 (95% CI: 0.76 to 0.86). Low adiponectin is associated with diabetes mellitus and has a high risk of incident diabetes mellitus, implying the potential of adiponectin as a predictive biomarker of diabetes mellitus in obese dogs.

Assessment of Anthropometric and Pubertal Growth of Children and Adolescents with Type 1 Diabetes Mellitus

Abstract Background Type 1 diabetes mellitus (T1DM) is a wasting disease which is characterized by a severe deficiency or absence of insulin. It can interfere with growth and pubertal development, especially in uncontrolled patients with diabetes. Aim of the Work Our primary aim was to assess the anthropometric measures and pubertal growth of children and adolescents with T1DM regularly attending Pediatric and Adolescents Diabetes Unit (PADU), Ain Shams University. Our secondary aim was to detect risk determinants affecting these measures and their link to glycemic control. Patients and Methods This cross-sectional observational study was carried out on 200 children and adolescents with T1DM attending the PADU clinic. Patients were assessed using anthropometric measurements, lipid profile (Fasting serum triglycerides, total cholesterol, HDL and LDL) and HbA1c%. Those with short stature were further evaluated using insulin like growth factor1 (IGF1), bone age, lipid profile and thyroid profile. while those with delayed puberty were evaluated using sex hormones. Results we found that 12.5% of our patients were short (SD&amp;lt;-2), Cut off point of IGF-1 SDS (≤ -1.2) and GF1( 2ng/ml) was low in72% of them. Diabetic patients with short stature have significantly earlier age of onset of diabetes, earlier age at diagnosis and longer duration of diabetes compared to those with normal stature (P &amp;lt; 0.05). Additionally, patients with short stature and those with delayed puberty have higher HbA1c. Patients with short stature also have higher lipid profile and lower IGF1 compared to those with normal stature (p &amp;lt; 0.05). Conclusion Children with uncontrolled T1DM are at risk of being short and had delayed puberty. IGF-1 level can be used as a screening test for short stature in diabetic children.

Clinical Features, Investigative Profile and Association with Metabolic Syndrome in Facial Acanthosis Nigricans: A Case–Control Study in Indian Patients

Objectives: The present study was undertaken to study the clinical profile and laboratory abnormalities in patients with facial acanthosis nigricans (FANs). The significance of FAN as a marker of insulin resistance (IR), metabolic syndrome (MS) and its components was determined by comparing with controls without FAN. Materials and Methods: Fifty clinically diagnosed cases of FAN of all ages and both sexes were enrolled. Age- and sex-matched obese patients without FAN were included as controls. Waist circumference, blood pressure and body mass index were measured. Venous samples were taken from all patients and controls for measuring fasting glucose level, fasting insulin levels and fasting lipid profile. Statistical analysis was done using the Chi-square test and unpaired t-test. Results: The prevalence of hypertension, dysglycaemia, hyperlipidaemia, elevated Homeostatic Model Assessment for IR (HOMA-IR) and MS was significantly higher in cases of FAN than controls (P &lt; 0.05). The mean levels of fasting blood sugar, HOMA-IR, hypertension, high-density lipoprotein and serum triglycerides were significantly higher in patients of FAN than controls (P &lt; 0.05). The odds ratio for FAN cases developing MS was determined to be 5.31. Conclusion: FAN may be considered as a significant clinical marker of IR with increased risk for MS and its component when compared to controls. All patients with FAN should be considered for a thorough biochemical workup to rule out MS. In all detected cases, it is prudent to initiate prompt remedial measures including lifestyle changes and pharmacotherapy to prevent long-term morbidity and mortality.

Triglyceride-Fasting Glucose Index and Homeostatic Model Assessment for Insulin Resistance as Predictors of Type 2 Diabetes Mellitus in South Indians With Normal Body Mass Index.

Early detection of type 2 diabetes mellitus (T2DM) is imperative to prevent the complications associated with the disease. Current guidelines for diagnosis rely on the assessment of serum glucose (fasting and post-prandial) and glycosylated hemoglobin (HbA1c) levels. Insulin resistance, a phenomenon associated with T2DM, has been observed before the changes in these metrics. The homeostatic model assessment for insulin resistance (HOMA-IR) has been widely used to assess the degree of insulin resistance. The triglyceride-fasting glucose (TyG) index is a newer marker of insulin resistance that merits further study. Aim: The study aimed to assess the validity of the TyG index and HOMA-IR as markers for the development of T2DM in non-obese individuals. Materials and methods:One hundred eight non-obese patients without T2DM were included in this prospective cohort study and followed up for eight years. Anthropometric and biochemical parameters, including fasting glucose levels, HbA1c, fasting serum insulin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG), were measured at enrolment and eight years follow-up, and HOMA-IR and TyG index were calculated. Results:Twenty participants out of 108 (18.5%) developed T2DM over eight years. On performing the area under the curve (AUC)-receiver operating characteristic curve analysis, TyG of >8.61 and HOMA-IR of >1.5 had the highest validity (ability) to predict new-onset T2DM in the study population (TyG: AUC: 0.612 (95% CI: 0.514-0.705); HOMA-IR: AUC: 0.529 (95% CI: 0.431-0.626)); however, this was not statistically significant. Conclusion:At an eight-year follow-up, TyG and HOMA-IR were unreliable predictors of the development of T2DM in non-obese individuals.

Fasting Triglycerides in the Upper Normal Range Are Independently Associated with an Increased Risk of Diabetes Mortality in a Large Representative US Population.

The association between normal-range triglyceride levels and diabetes mortality remains unclear. This cohort study aimed to elucidate this relationship by examining 19,010 US adult participants with fasting serum triglycerides below 150 mg/dL. Cox proportional hazards models were employed to estimate mortality hazard ratios (HRs) and 95% confidence intervals (CIs). Participants were followed up for a mean of 15.3 years, during which 342 diabetes deaths were recorded. A 1 natural log unit increase in triglycerides was associated with a 57% higher risk of diabetes mortality (adjusted HR, 1.57; 95% CI, 1.04-2.38). Comparable results were obtained when triglycerides were analyzed in quartiles. Receiver operating characteristic curve analysis identified an optimal triglyceride cutoff of 94.5 mg/dL for diabetes mortality; individuals with triglyceride levels above this threshold faced a greater risk of diabetes mortality (adjusted HR, 1.43; 95% CI, 1.12-1.83). Further investigation revealed a positive association between normal triglyceride levels and all-cause mortality, though no association was observed between normal triglycerides and mortality from hypertension or cardiovascular disease. In conclusion, elevated triglyceride levels within the normal range were associated with an increased risk of diabetes mortality. Individuals with triglyceride levels of 95 mg/dL or higher may require vigilant monitoring for diabetes and its associated complications.

Daily spiritual experiences and allostatic load trajectories: a longitudinal study of midlife African American women.

This study aimed to evaluate the association between daily spiritual experiences and allostatic load (AL) trajectories in midlife African American women. A longitudinal analysis of public-use data from 727 African American women in the Study of Women's Health Across the Nation (SWAN) was performed. We included African American women who completed the Daily Spiritual Experiences Scale at SWAN visit 4 (2000-2001) and had AL data at three or more study visits over 7 years. AL was calculated at each visit using 10 biomarkers: systolic and diastolic blood pressure, body mass index, C-reactive protein, high-density lipoprotein cholesterol, total cholesterol, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone. Group-based trajectory modeling identified women with similar patterns of AL. We used multinomial logistic regression to estimate associations between daily spiritual experiences (some days or less, most days, daily, many times a day) and AL trajectories. Our sample had a mean ± SD age of 49.9 ± 2.66 years, 47% were early perimenopausal, and 17% earned <$19,999 annually. The mean ± SD AL score was 2.52 ± 1.68. Three AL trajectories were identified: low (35.1%), moderate (44.7%), and high (20.2%). In age-adjusted models, women who reported daily comfort in religion and spirituality were less likely to follow a high AL trajectory (odds ratio, 0.41; 95% CI, 0.18-0.93); the association was attenuated when controlling for depressive symptoms (odds ratio, 0.48; 95% CI, 0.19-1.21). Findings from this study do not support an independent association between spirituality in African American women and AL trajectories in midlife. Studies with a larger sample and additional measures of spirituality are warranted in this population.

Changes in liver health biomarkers following consumption of energy restricted diets containing almonds compared with carbohydrate-rich snack foods for 9 months

Energy restricted diets improve liver function(1) and habitual nut consumption has been associated with a lower prevalence of fatty liver(2). This study examined the effect of incorporating almonds in an energy restricted diet on liver health biomarkers. One Hundred and forty adults (42M:98F, 47.5 ± 10.8 years, BMI 30.7 ± 2.3 kg/m2) enrolled in a 9-month (9M) dietary intervention comprising 3 months (3M) weight loss (30% energy restriction) followed by 6 months (6M) of weight maintenance. Participants were randomly assigned to consume almonds (n = 68, AED) or isocaloric carbohydrate-rich snacks (n = 72, CRD) which provided 15% of total daily energy. At baseline (BL), 3M and 9M, fatty liver index (FLI) scores (0-100)(3) were calculated using body mass index (BMI), waist circumference (WC), fasting serum gamma-glutamyl transferase (GGT) and triglyceride (TAG) levels, and other liver health biomarkers were assessed by ultrasound (volume, visual appearance and elastography (a marker of stiffness due to fibrosis)). Intention to treat analyses were conducted using mixed effects modelling (fixed effects group and time, with participants as the random effect). Significant reductions from BL occurred over time (all p&lt;0.001 for 3M and 9M) with no difference between groups (AED vs CRD, P&gt;0.05) in BMI (3M: −2.44 ± 0.20 vs −2.32 ± 0.20, 9M: −2.83 ± 0.19 vs −2.81 ± 0.19 kg/m2), WC (3M: −8.04 ± 0.79 vs −7.00 ± 0.81, 9M: −8.72 ± 0.83 vs −9.14 ± 0.81 cm), TAG (3M: −0.24± 0.08 vs −0.22 ± 0.09, 9M: −0.37 ± 0.09 vs −0.21 ± 0.09 mmol/L), FLI score (3M: −23.8 ± 2.0 vs −17.6 ± 2.1, 9M: −23.8 ± 2.0 vs −17.6 ± 2.1), and liver volume (3M: −134.56 ± 38.30 vs −100.96 ± 37.25, 9M: −113.68 ± 37.42 vs −110.64 ± 35.47cm3). Significantly greater reductions occurred for AED compared to CRD at 3M and 9M in GGT (p = 0.003) (3M: −9.68 ± 1.93 vs −0.01 ± 2.00, 9M: −7.75 ± 2.06 vs −2.78 ± 2.15 IU/L) and liver visual assessment scores (p = 0.03) (3M: −0.58 ± 0.24 vs −0.45 ± 0.23, 9M: −1.33 ± 0.23 vs −0.50 ± 0.22). There were no significant changes in liver elastography over time or between groups. Energy restriction improved body composition and reduced the extent of fatty liver and liver size but did not change liver stiffness. The inclusion of almonds in an energy restricted diet demonstrated additional benefits to some liver health biomarkers providing support for almonds being incorporated into lifestyle interventions to improve liver function.

Dyslipidemia, body mass index, and blood glucose levels in patients with meibomian gland dysfunction

Background Systemic dyslipidemia, obesity, and elevated blood sugars may theoretically affect the meibomian lipid composition and therefore, can cause meibomian gland dysfunction (MGD). Objective This study aimed to evaluate the association of serum lipid levels, body mass index (BMI), and serum blood glucose (BG) levels in patients with MGD compared with healthy controls. Patients and methods This is a comparative observational case-control study that enrolled 40 MGD patients (cases) and 40 controls. One eye of each participant was included in the study. After a detailed history, ocular examination was done by slit lamp biomicroscopy to grade/stage the MGD. The BMI, serum fasting total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and BG levels were measured. Results The mean age of the cases was 46.75±10.93 years compared with 45.55±10.62 years in controls (P=0.620). Patients with MGD showed significantly higher serum fasting cholesterol (188.62±62.24 mg/dl),;Deg;BM;Deg;I (24.45±1.75 kg/m2), and fasting BG (110.35±32.30 mg/dl) compared with the controls (159.60±20.19 mg/dl, 23.45±1.35 kg/m2, and 98.43±27.69 mg/dl, respectively, P=0.022, 0.005, and 0.030, respectively). With increasing severity of MGD, the fasting serum cholesterol increased significantly from 136.73±24.88 mg/dl in grade 1 to 285.20±85.99 mg/dl in grade 4 (P&lt;0.001) and the fasting serum LDL levels increased from 72.64±20.33 mg/dl in grade 1 to 202.60±95.66 mg/dl in grade 4 (P&lt;0.001). In addition, the fasting serum triglycerides increased significantly as the severity of MGD increased from grade I (96.00±22.56 mg/dl) to grade III (227.09±83.44 mg/dl), (P&lt;0.001). However, The fasting HDL and BG values did not increase significantly with increasing severity of the MGD (P=0.135 and 0.181, respectively). Conclusion There is importance for screening for dyslipidemia, BMI, and BG levels in MGD cases.

Measurement of Arginase Activity in Sera of Iraqi Acromegaly Patients with Diabetes

The goal of this study was to measure arginase enzyme activity in diabetic acromegaly Iraqi patients and compare it to a control group. This study included 80 participants, whose ages ranged from 25 to 65, and was conducted on forty diabetic acromegaly Iraqi patients attending the national diabetes center of Mustansiriyah University in Baghdad and forty healthy individuals (as a control group). The results showed a highly significant reduction in arginase activity and High-density lipoprotein-cholesterol (HDL-C), Urea levels were reduced not significantly, whereas a highly significant increase in levels of Growth Hormone (GH), Insulin-Like Growth Factor-1 (IGF-1), Fasting Serum glucose (FSG), Total Cholesterol (TC), Triglycerides (TG), Low-density lipoprotein-cholesterol (LDL-C), and Very low-density lipoprotein-cholesterol (VLDL-C)) compared to control. A significant positive correlation was revealed between arginase activity and FSG levels in diabetic acromegaly patients. In conclusion, diabetic acromegaly patients had a significant decreased in serum arginase activity with no significant decrease urea levels, which indicates that their bodies store more nitrogen compounds to be utilized in constructing processes.

Synergistic interaction between hyperlipidemia and obesity as a risk factor for stress urinary incontinence in Americans

Urinary incontinence is a common disease among middle-aged and elderly women, which not only affects the physical and mental health of patients, but also brings a great medical burden to society. Obesity is a known risk factor for urinary incontinence and is the most common secondary cause of hyperlipidemia. Most obese patients also suffer from hyperlipidemia in the clinic. However, few studies have explored the role of hyperlipidemia in women with urinary incontinence. Using data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES), we aimed to evaluated the independent associations of high body mass index and hyperlipidemia with urinary incontinence in Americans by conducting a weighted multivariate logistic regression model. Additive interactions were also assessed using the relative excess risk due to interaction (RERI), attributed proportion of interaction (AP) and synergy index (S). This study demonstrated that hyperlipidemia was associated with a higher risk of stress urinary incontinence among women with obesity (OR = 1.52, 95% CI = 1.03–2.25), and there was a significant synergistic effect of hyperlipidemia and obesity on stress urinary incontinence(adjusted RERI: 3.75, 95% CI 0.30–7.20; adjusted AP: 0.67, 95% CI 0.54–0.80; adjusted S: 5.49, 95% CI 4.15–7.27). Moreover, fasting serum triglyceride lipids were the most relevant blood lipid indicator for the risk of stress urinary incontinence, especially among obese women younger than 50 years old, which contributes to the development of more refined lipid control protocols for patients with urinary incontinence in different age groups.