Lack of age-related increase in average glycemia in a non-Westernized sample of rural Yucatec Maya females

Determinants of fructosamine levels in a multi-ethnic Sub-Saharan African population

BACKGROUND AND PURPOSE

Fructosamine provides an estimate of diabetes control over a shorter period than HbA1c, and has been proposed as a suitable parameter to monitor glycemic control in low-income countries. The aim of this study was to investigate determinants of fructosamine levels in an urban non-diabetic population of Cameroon.

METHODS

This was a cross-sectional study including 437 healthy adults with no known history of diabetes mellitus, aged 40 years and above, recruited from the ten administrative regions, representing major ethnic groups in the country. Plasma glucose and fructosamine were measured after an overnight fasting. Univariable and multivariable analyses were used to investigate the factors associated with fructosamine measurements.

RESULTS

Fructosamine levels ranged from 68.2 to 940.8 μmol/l with a mean (standard deviation) of 294.4 (131.3) μmol/l. These levels varied significantly across regions and were higher in men than in women (p=0.001) and in those with screen-detected diabetes than in those with normoglycemia (p<0.0001). There was a negative correlation between fructosamine and body mass index (r=-0.15, p=0.009), and a positive correlation with fasting plasma glucose (FPG) (r=0.37, p<0.0001) and total bilirubinemia (r=0.21, p<0.0001). In multivariable model, sex, BMI, FPG, total bilirubine and screen-detected diabetes were no longer associated with fructosamine levels.

CONCLUSION

Fructosamine was not independently associated with age, sex, ethnicity, and the glycemic status. Further studies need to be carried out to better elucidate all the factors determining the measurement of fructosamine in order to accurately interpret its values in diabetic populations.

Involvement of advanced glycation end products in the pathogenesis of diabetic complications: the protective role of regular physical activity

Advanced glycation end products (AGEs) may play an important role in the pathogenesis of chronic diabetic complications and in the natural process of biological aging. In fact, maintained hyperglycaemia favours the formation of AGEs at the tissue level in diabetic patients, which may influence the triggering of different chronic pathologies of diabetes such as retinopathy, nephropathy, neuropathy and macro- and micro-vascular diseases. Moreover, the literature has also demonstrated the involvement of AGEs in biological aging, which may explain the accelerated process of aging in diabetic patients. The practice of regular physical activity appears to positively influence glycaemic control, particularly in type 2 diabetes mellitus patients. This occurs through the diminution of fasting glycaemia, with a consequent reduction of glycation of plasmatic components suggested by the normalisation of HbA1c plasmatic levels. This exercise-induced positive effect is evident in the blood of diabetic patients and may also reach the endothelium and connective tissues of different organs, such as the kidneys and eyes, and systems, such as the cardiovascular and nervous systems, with a local reduction of AGEs production and further deceleration of organ dysfunction. The aim of this paper was to review the literature concerning this topic to coherently describe the harmful effects of AGEs in organ dysfunction induced by diabetes in advanced age as well as the mechanisms behind the apparent protection given by the practice of regular physical activity.

Anthropometric patterns in middle-aged and older rural Yucatec Maya women

BACKGROUND

Cross-cultural variation in body composition changes with age has not been fully investigated. Although studies involving anthropometric measurements of older people have been reported for some non-Westernized populations, little such research has been conducted in Latin America.

AIM

This study examines patterns associated with age in anthropometric indicators among a rural Maya population in Yucatán, México. Middle and older ages are included to promote a comprehensive age portrayal.

SUBJECTS AND METHODS

Stature, weight, and six trunk and limb circumferences were collected from 60 women aged 40.8-85.6 years. Several ratios and indices were also derived.

RESULTS

Age was strongly and negatively related to all body size and adiposity measures (beta from -0.422 to -0.603, p < 0.001). Associations between age and ratios/indices of adipose tissue distribution were positive and not as pronounced (beta from 0.280, p < 0.05 to 0.429, p < 0.001). Age had the largest negative influence on arm circumference, mid-thigh circumference, and weight (R2 = 0.36, p < 0.001) and the greatest positive impact on umbilicus/arm ratio (R2 = 0.18, p < 0.001).

CONCLUSIONS

Three major anthropometric patterns are demonstrated: in successively older women, muscle mass is significantly lower, central adipose tissue predominance is significantly greater, and overall adiposity is significantly lower. In the first two patterns, Maya women conform to findings from Western settings; in the latter pattern, these women diverge from Western results, but corroborate findings from some non-Westernized groups.