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Wu J, Yu W, Xu Z, Chen Y, Li J, Sun Q. Dietary Knowledge, Attitude, Practice Survey and Nutritional Knowledge-Based Intervention: A Cross-Sectional and Randomized Controlled Trial Study among College Undergraduates in China. Nutrients 2024; 16:2365. [PMID: 39064808 PMCID: PMC11279395 DOI: 10.3390/nu16142365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Understanding undergraduates' dietary literacy, including dietary knowledge, attitude and practice (KAP), is important for future health promotion policies. Therefore, this study aimed to investigate the current status and influencing factors of dietary literacy in Chinese college undergraduates and explore whether a nutritional lecture could improve their dietary literacy. METHODS This study included two parts: a cross-sectional study (n = 1026) conducted by a dietary literacy questionnaire, and a randomized controlled trail (RCT) that enrolled 99 college undergraduates who were randomized to a control group or a nutritional lecture group. Data from the questionnaire and 72 h food records were obtained on day 0, day 3 and day 100 before and after intervention. RESULTS This cross-sectional study showed that the mean scores of dietary KAP were respectively 100.0 (33.3), 59.1 (13.6) and 71.7 (11.7), with an excellent rate of 36.6%, 1.9% and 3.4%. Female upper-grade undergraduates and those with medicine-related majors illustrated higher dietary knowledge scores (p < 0.001). Dietary attitude rather than dietary knowledge had a significant impact on dietary practice (p < 0.001). This finding was in line with the results in the RCT study. Compared with the control group, dietary knowledge was significantly improved in the nutritional lecture group on both day 3 (p = 0.002) and day 100 (p = 0.023) after intervention. However, dietary behavior was improved only on day 3 post nutritional lecture (p = 0.029) but decreased to the original level 100 days later (p < 0.001). CONCLUSIONS This study discovered the unsatisfying status and discrepancy between dietary literacy among college undergraduates of different sex, majors and college years. Dietary attitude instead of dietary knowledge was discovered as a determining role in dietary practice. One nutritional lecture could improve undergraduates' dietary literacy but the effect was not long-lasting. Further studies with more reinforced and durable interventions are warranted.
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Affiliation(s)
- Junjie Wu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Wei Yu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China;
| | - Zhuo Xu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yuxuan Chen
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Jiaomei Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Qinghua Sun
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Lu Z, Zhang H, Yang Y, Zhao H. Sex differences of the shared genetic landscapes between type 2 diabetes and peripheral artery disease in East Asians and Europeans. Hum Genet 2023:10.1007/s00439-023-02573-x. [PMID: 37341850 DOI: 10.1007/s00439-023-02573-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/12/2023] [Indexed: 06/22/2023]
Abstract
Type 2 diabetes (T2D) is a critical risk factor for peripheral artery disease (PAD). However, the sex differences in genetic basis, causality, and underlying mechanisms of the two diseases are still unclear. Using sex-stratified and ethnic-based GWAS summary, we explored the genetic correlation and causal relationship between T2D and PAD in both ethnicities and sexes by linkage disequilibrium score regression, LAVA and six Mendelian Randomization approaches. We observed stronger genetic correlations between T2D and PAD in females than males in East Asians and Europeans. East Asian females exhibit higher causal effects of T2D on PAD than males. The gene-level analysis found KCNJ11 and ANK1 genes associated with the cross-trait of T2D and PAD in both sexes. Our study provides genetic evidence for the sex difference of genetic correlations and causal relationships between PAD and T2D, indicating the importance of using sex-specific strategies for monitoring PAD in T2D patients.
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Affiliation(s)
- Zhiya Lu
- Department of Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, China
| | - Haoyang Zhang
- School of Data and Computer Science, Sun Yat-sen University, Guangzhou, China
| | - Yuanhao Yang
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Huiying Zhao
- Department of Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, China.
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Yun A, Luo Y, Calache H, Wang Y, Darby I, Lau P. Diabetes and Oral Health (DiabOH): The Perspectives of Primary Healthcare Providers in the Management of Diabetes and Periodontitis in China and Comparison with Those in Australia. Healthcare (Basel) 2022; 10:healthcare10061032. [PMID: 35742083 PMCID: PMC9223094 DOI: 10.3390/healthcare10061032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/10/2022] [Accepted: 05/30/2022] [Indexed: 11/22/2022] Open
Abstract
Diabetes and periodontal disease are highly prevalent conditions around the world with a bilateral causative relationship. Research suggests that interprofessional collaboration can improve care delivery and treatment outcomes. However, there continues to be little interprofessional management of these diseases. DiabOH research aims to develop an interprofessional diabetes and oral health care model for primary health care that would be globally applicable. Community medical practitioners (CMPs), community health nurses (CNs), and dentists in Shanghai were recruited to participate in online quantitative surveys. Response data of 76 CMPs, CNs, and dentists was analysed for descriptive statistics and compared with Australian data. Health professionals in China reported that, while screening for diabetes and periodontitis, increasing patient referral and improving interprofessional collaboration would be feasible, these were not within their scope of practice. Oral health screening was rarely conducted by CMPs or CNs, while dentists were not comfortable discussing diabetes with patients. Most participants believed that better collaboration would benefit patients. Chinese professionals concurred that interprofessional collaboration is vital for the improved management of diabetes and periodontitis. These views were similar in Melbourne, except that Shanghai health professionals held increased confidence in managing patients with diabetes and were more welcoming to increased oral health training.
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Affiliation(s)
- Andrew Yun
- Department of General Practice, The University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Yuan Luo
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200120, China;
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai 200120, China;
| | - Hanny Calache
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2751, Australia;
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Flora Hill, VIC 3550, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Yan Wang
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai 200120, China;
- Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200120, China
| | - Ivan Darby
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Phyllis Lau
- Department of General Practice, The University of Melbourne, Melbourne, VIC 3010, Australia;
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2751, Australia;
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC 3010, Australia;
- Department of General Practice, School of Medicine, Western Sydney University, Sydney, NSW 2751, Australia
- Correspondence:
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Liu Y, Li J, Wu Y, Zhang H, Lv Q, Zhang Y, Zheng X, Tong N. Evidence From a Systematic Review and Meta-Analysis: Classical Impaired Glucose Tolerance Should Be Divided Into Subgroups of Isolated Impaired Glucose Tolerance and Impaired Glucose Tolerance Combined With Impaired Fasting Glucose, According to the Risk of Progression to Diabetes. Front Endocrinol (Lausanne) 2022; 13:835460. [PMID: 35250886 PMCID: PMC8894674 DOI: 10.3389/fendo.2022.835460] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/17/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The American Diabetes Association (ADA) 2003 diagnostic criteria divide impaired glucose tolerance (IGT) into isolated impaired glucose tolerance with normal fasting glucose (I-IGT, IGT+NFG) and impaired glucose tolerance combined with impaired fasting glucose (IGT+IFG), while the World Health Organization (WHO) 1999 criteria do not. The aim of this meta-analysis was to evaluate whether IGT should be divided into I-IGT (IGT+NFG) or IGT+IFG according to their risk of progression to type 2 diabetes. METHODS The MEDLINE and EMBASE were searched to identify prospective cohort studies published in English prior to April 18, 2020. Review Manager 5.3 was used to calculate the pooled risk ratios (RRs) and 95% confidence intervals (CIs) as summary statistics for each included study. RESULTS Sixteen eligible studies (n = 147,006) were included in the analysis. The subsequent incidence of type 2 diabetes was lower in the I-IGT (IGT+NFG) group than in the IGT+IFG group (0.45 [95% CI 0.37, 0.55] according to WHO 1999 criteria and 0.59 [95% CI 0.54, 0.66] according to ADA 2003 criteria). It was higher in the I-IFG, I-IGT (IGT+NFG), and IGT+IFG groups than in the normoglycemic group (95% CI of 5.53 [3.78, 8.08], 5.21 [3.70, 7.34], and 11.87 [7.33, 19.20] according to the WHO 1999 criteria and 95% CI of 2.66 [2.00, 3.54], 3.34 [2.81, 3.97], and 6.10 [4.72, 7.88] according to the ADA 2003 criteria). In general, the incidence of diabetes in the IGT+IFG group was the highest in the prediabetic population. CONCLUSIONS The present meta-analysis suggested that the established WHO diagnostic criteria for IGT should be revised to separately identify individuals with IGT+NFG or IGT+IFG.
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Affiliation(s)
- Yupu Liu
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Juan Li
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Yuchao Wu
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Han Zhang
- Department of Endocrinology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qingguo Lv
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Yuwei Zhang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaofeng Zheng
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
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Toi PL, Wu O, Thavorncharoensap M, Srinonprasert V, Anothaisintawee T, Thakkinstian A, Phuong NK, Chaikledkaew U. Economic evaluation of population-based type 2 diabetes mellitus screening at different healthcare settings in Vietnam. PLoS One 2021; 16:e0261231. [PMID: 34941883 PMCID: PMC8700026 DOI: 10.1371/journal.pone.0261231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Few economic evaluations have assessed the cost-effectiveness of screening type-2 diabetes mellitus (T2DM) in different healthcare settings. This study aims to evaluate the value for money of various T2DM screening strategies in Vietnam. Methods A decision analytical model was constructed to compare costs and quality-adjusted life years (QALYs) of T2DM screening in different health care settings, including (1) screening at commune health station (CHS) and (2) screening at district health center (DHC), with no screening as the current practice. We further explored the costs and QALYs of different initial screening ages and different screening intervals. Cost and utility data were obtained by primary data collection in Vietnam. Incremental cost-effectiveness ratios were calculated from societal and payer perspectives, while uncertainty analysis was performed to explore parameter uncertainties. Results Annual T2DM screening at either CHS or DHC was cost-effective in Vietnam, from both societal and payer perspectives. Annual screening at CHS was found as the best screening strategy in terms of value for money. From a societal perspective, annual screening at CHS from initial age of 40 years was associated with 0.40 QALYs gained while saving US$ 186.21. Meanwhile, one-off screening was not cost-effective when screening for people younger than 35 years old at both CHS and DHC. Conclusions T2DM screening should be included in the Vietnamese health benefits package, and annual screening at either CHS or DHC is recommended.
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Affiliation(s)
- Phung Lam Toi
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Health Strategy and Policy Institute, Ministry of Health, Hanoi, Vietnam
| | - Olivia Wu
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Montarat Thavorncharoensap
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Faculty of Pharmacy, Social and Administrative Pharmacy Division, Department of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Varalak Srinonprasert
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Faculty of Medicine Siriraj Hospital, Health Policy Unit, Mahidol University, Bangkok, Thailand
| | - Thunyarat Anothaisintawee
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Faculty of Medicine Ramathibodi Hospital, Department of Family Medicine, Mahidol University, Bangkok, Thailand
| | - Ammarin Thakkinstian
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Faculty of Medicine Ramathibodi Hospital, Department of Clinical Epidemiology and Biostatistics, Mahidol University, Bangkok, Thailand
| | | | - Usa Chaikledkaew
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Faculty of Pharmacy, Social and Administrative Pharmacy Division, Department of Pharmacy, Mahidol University, Bangkok, Thailand
- * E-mail:
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[Prevalence of chronic kidney disease in Antananarivo, Madagascar]. Nephrol Ther 2021; 18:29-34. [PMID: 34920974 DOI: 10.1016/j.nephro.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/17/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Chronic kidney disease is defined as an inability of the kidney to perform its normal functions and which persists beyond three months. Nowadays, the estimated glomerular filtration rate based on plasmatic creatinine level remains the gold standard to assess renal function. In Madagascar, we miss national data concerning the epidemiology of chronic kidney disease probably due to the complexity of carrying out the serum creatinine assays. The recent availability of creatinometer using a creatinine strip test with capillary creatinine facilitated the determination of the creatinine level in epidemiological study. PATIENTS AND METHODS This simple technique allowed us to plan a pilot study in Antananarivo, the capital of Madagascar. The main objective was to assess the prevalence of chronic kidney disease determined from capillary creatinine level. The secondary objective was to determine the factors associated with chronic kidney disease in Madagascar. It is an analytical cross-sectional study over a period of three months. Chronic kidney disease is defined as a decrease of the glomerular filtration rate of capillary creatinine less than 60mL/min/1.73m2 and calculated with Chronic Kidney Disease Epidemiology formula (CKD-EPI). The minimum number of studied population has been assessed and settled at 210 people. Cluster sampling was performed for randomization of participants. RESULTS At the end of the study, 210 people were randomized for screening. The average age was 40 years old with 14.9 as standard deviation. The sex ratio (male/female) was 1.76. The prevalence of chronic kidney disease was 13.8% with extreme values of 9,1 and 18.5. With chronic kidney disease, high blood pressure (hypertension) and diabetes were found respectively in 41.3 and 17.2%. Chronic kidney disease affected mainly in 72.4% of population aged 25 to 54 years old. CONCLUSION This is the first study in Africa to screen chronic kidney disease using a creatinine strip test. This prevalence is relatively different compared to other African countries. The limits of the study are the absence of a subsequent control and/or double control of the creatinine, which definitively confirms the chronicity of kidney disease, the absence evaluation of the urinary sediments to determine proteinuria. Nevertheless, the results of our study can be used as data awaiting the results of a multicenter studies. To determine the national prevalence of chronic kidney disease, screening in the six provinces is currently in progress.
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Hu T, Li W, Xu K, Chen K, Li X, Yi H, Ni Z. Portable and Intelligent Urine Glucose Analyzer Based on a CdTe QDs@GOx Aerogel Circular Array Sensor. ACS OMEGA 2021; 6:32655-32662. [PMID: 34901614 PMCID: PMC8655949 DOI: 10.1021/acsomega.1c03449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/26/2021] [Indexed: 05/05/2023]
Abstract
Diabetes is a public health problem characterized by hyperglycemia, high mortality, and morbidity. A simple, rapid, and sensitive glucose detection method for diabetes screening and health self-management of patients with diabetes is of great significance. Therefore, an attractive urine glucose (UG) analyzer with advantages of fastness, sensitivity, and portability was developed. A cadmium telluride quantum dots (CdTe QDs)@glucose oxidase (GOx) aerogel circular array sensor can emit visible red fluorescence when excited by a 365 nm ultraviolet light source inside the analyzer. When urine samples containing glucose were dropped onto the sensor, glucose was oxidized by GOx to produce hydrogen peroxide (H2O2), which quenched the red fluorescence of CdTe QDs. The fluorescence images of the sensor were obtained using a CCD camera, and the linear relationship between the glucose concentration and the gray value of the fluorescence image was established. The analyzer shows good sensitivity (LOD, 0.12 mM) with a wide linear range of 0.12-26 mM. Based on the linear relation, the software of the analyzer was written in the C++ language, which can automatically give the gray value of the image and the corresponding glucose concentration. The UG analyzer was used for the detection of a large number clinical samples and compared with a variety of UG test papers, which all showed good detection performance. The novel analyzer we proposed has an important significance in the screening of diabetes and the self-management of diabetic patients.
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Affiliation(s)
| | | | | | | | - Xiao Li
- .
Phone: 86-025-52090518. Fax: 86-025-52090504
| | - Hong Yi
- . Phone: 86-025-52090504. Fax: 86-025-52090504
| | - Zhonghua Ni
- . Phone: 86-025-52090518. Fax: 86-025-52090504
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Yu J, Yi Q, Hou L, Chen G, Shen Y, Song Y, Zhu Y, Song P. Transition of Lipid Accumulation Product Status and the Risk of Type 2 Diabetes Mellitus in Middle-Aged and Older Chinese: A National Cohort Study. Front Endocrinol (Lausanne) 2021; 12:770200. [PMID: 34899605 PMCID: PMC8660859 DOI: 10.3389/fendo.2021.770200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background Lipid accumulation product (LAP), a product of waist circumference (WC) and fasting triglycerides (TG), is a measure of lipid accumulation and an effective predictor of metabolic syndrome. This study aimed to evaluate the associations of LAP and its longitudinal transitions with type 2 diabetes mellitus (T2DM) among middle-aged and older Chinese. Methods Data were extracted from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). LAP was defined as (WC-65) ×TG for men, and (WC-58) ×TG for women. Participants were classified into high- and low-LAP groups at baseline, and subsequently into four transition patterns during 2011-2015: maintained-high, maintained-low, high-to-low, and low-to-high LAP. The longitudinal transition patterns of LAP on the development of T2DM were assessed by multivariable Cox frailty models. Results Overall, 7397 participants were included for analysis, among whom 849 (11.5%) developed T2DM between 2011 and 2018. Women with high-LAP levels at baseline presented a higher risk of T2DM (hazard ratios [HR]=1.37, 95% confidence interval [CI]: 1.07-1.77), while no significant association was found in men. Compared with women with maintained-low LAP pattern, those with transition patterns of low-to-high LAP and maintained-high LAP were at higher risk of T2DM (HR =1.99 and 1.98, both P<0.05); however, for men, the significantly positive association was only observed in maintained-high LAP transition pattern (HR=1.53, 95% CI: 1.04-2.23). Conclusions Elevated LAP levels and the transition patterns of maintained-high LAP and low-to-high LAP are significant risk factors for T2DM in women. Preventions are needed to combat T2DM at an early dyslipidemic stage.
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Affiliation(s)
- Jinyue Yu
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Institute of Child Health, University College London, London, United Kingdom
| | - Qian Yi
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leying Hou
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ge Chen
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing, China
| | - Yaojia Shen
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Song
- School of Nursing, Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Yimin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Hyocholic acid species as novel biomarkers for metabolic disorders. Nat Commun 2021; 12:1487. [PMID: 33674561 PMCID: PMC7935989 DOI: 10.1038/s41467-021-21744-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 01/29/2021] [Indexed: 01/07/2023] Open
Abstract
Hyocholic acid (HCA) is a major bile acid (BA) species in the BA pool of pigs, a species known for its exceptional resistance to spontaneous development of diabetic phenotypes. HCA and its derivatives are also present in human blood and urine. We investigate whether human HCA profiles can predict the development of metabolic disorders. We find in the first cohort (n = 1107) that both obesity and diabetes are associated with lower serum concentrations of HCA species. A separate cohort study (n = 91) validates this finding and further reveals that individuals with pre-diabetes are associated with lower levels of HCA species in feces. Serum HCA levels increase in the patients after gastric bypass surgery (n = 38) and can predict the remission of diabetes two years after surgery. The results are replicated in two independent, prospective cohorts (n = 132 and n = 207), where serum HCA species are found to be strong predictors for metabolic disorders in 5 and 10 years, respectively. These findings underscore the association of HCA species with diabetes, and demonstrate the feasibility of using HCA profiles to assess the future risk of developing metabolic abnormalities.
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Hu W, Xu W, Si L, Wang C, Jiang Q, Wang L, Cutler H. Cost-effectiveness of the Da Qing diabetes prevention program: A modelling study. PLoS One 2021; 15:e0242962. [PMID: 33382746 PMCID: PMC7774969 DOI: 10.1371/journal.pone.0242962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 11/12/2020] [Indexed: 12/17/2022] Open
Abstract
Objective The Da Qing Diabetes Prevention program (DQDP) was a randomized lifestyle modification intervention conducted in 1986 for the prevention and control of type 2 diabetes in individuals with impaired glucose tolerance. The current study estimated long-term cost-effectiveness of the program based on the health utilities from the Chinese population. Methods A Markov Monte Carlo model was developed to estimate the impact of the intervention from the healthcare system perspective. The analysis was run over 30-year and lifetime periods and costs were estimated respectively as health management service costs. Baseline characteristics and intervention effects were assessed from the DQDP. Utilities and costs were generated from relevant literature. The outcome measures were program cost per quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio (ICER) of the intervention. Sensitivity analyses and threshold analyses were performed. Results Using a 30-year horizon, the intervention strategy was cost-saving and was associated with better health outcomes (increase of 0.74 QALYs per intervention participant). Using a lifetime horizon, the intervention strategy was cost-saving and was associated with additional 1.44 QALYs. Sensitivity analyses showed that the overall ICER was most strongly influenced by the hazard ratio of cardiovascular disease event. Conclusions The Da Qing lifestyle intervention in a Chinese population with impaired glucose tolerance is likely to translate into substantial economic value. It is cost-saving over a 30-year time and lifetime frame.
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Affiliation(s)
- Wanxia Hu
- School of Health Management, Anhui Medical University, Hefei, China
| | - Wenhua Xu
- Affiliated Stomatological Hospital, Anhui Medical University, Hefei, China
| | - Lei Si
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Cuilian Wang
- School of Health Management, Anhui Medical University, Hefei, China
| | - Qicheng Jiang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Lidan Wang
- School of Health Management, Anhui Medical University, Hefei, China
- Centre for the Health Economic, Macquarie University, Sydney, New South Wales, Australia
- * E-mail:
| | - Henry Cutler
- Centre for the Health Economic, Macquarie University, Sydney, New South Wales, Australia
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Chen J, Sun H, Qiu S, Tao H, Yu J, Sun Z. Lipid Accumulation Product Combined With Urine Glucose Excretion Improves the Efficiency of Diabetes Screening in Chinese Adults. Front Endocrinol (Lausanne) 2021; 12:691849. [PMID: 34497582 PMCID: PMC8419462 DOI: 10.3389/fendo.2021.691849] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND To compare the efficacy of lipid accumulation product (LAP) and urine glucose excretion (UGE) in predicting diabetes and evaluate whether the combination of LAP and UGE would help to improve the efficacy of using LAP alone or UGE alone in identifying diabetes. METHODS Data from 7485 individuals without prior history of diabetes who participated in a cross-sectional survey in Jiangsu, China, were analyzed. Each participant underwent an oral glucose-tolerance test. Operating characteristic curves (ROC) and logistic regression analyses were used to evaluate the performance of LAP and UGE in identification of newly diagnosed diabetes (NDM) and prediabetes (PDM). RESULTS For subjects with NDM, the area under the ROC curve was 0.72 for LAP and 0.85 for UGE, whereas for PDM, these values were 0.62 and 0.61, respectively. Furthermore, LAP exhibited a comparable sensitivity with UGE in detecting NDM (76.4% vs 76.2%, p = 0.31). In predicting PDM, LAP showed a higher sensitivity than UGE (66.4% vs 42.8%, p < 0.05). The combination of LAP and UGE demonstrated a significantly higher sensitivity than that of LAP alone and UGE alone for identification of NDM (93.6%) and PDM (80.1%). Moreover, individuals with both high LAP and high UGE had significantly increased risk of NDM and PDM than those with both low LAP and low UGE. CONCLUSIONS The combination of LAP and UGE substantially improved the efficacy of using LAP and using UGE alone in detecting diabetes, and may be a novel approach for mass screening in the general population.
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Affiliation(s)
- Juan Chen
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, China
| | - Hong Sun
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, China
- Department of Endocrinology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Hu Tao
- School of Mechanical Engineering, and Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing, China
| | - Jiangyi Yu
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Zilin Sun, ; Jiangyi Yu,
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, China
- *Correspondence: Zilin Sun, ; Jiangyi Yu,
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Shi FH, Shen L, Pan MM, Ma LL, Zhang C, Gu ZC, Ma J, Li H. The Successful Rapid Adjustment of Blood Glucose in a Patient With Acute Coronary Syndrome, Renal Insufficiency, and Diabetes: A Case Report of Management Coordinated by Clinical Pharmacists and Clinicians. Front Pharmacol 2020; 11:756. [PMID: 32528289 PMCID: PMC7253704 DOI: 10.3389/fphar.2020.00756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 05/06/2020] [Indexed: 12/25/2022] Open
Abstract
Diabetes is a major cause of cardiovascular mortality in most countries. Intensive management of blood glucose is pivotal for alleviating disease progress and minimizing cardiovascular complications. In this study, we report a case of successful control of high blood glucose in a diabetes patient with acute coronary syndromes (ACS), hypertension, and renal insufficiency. This patient had five years of diabetes history and was hospitalized through an ACS emergency. Coronary angiography showed an acute anterior myocardial infarction (Killip Level I). The patient had extremely high blood glucose that ranged from 19.4 to 28.2 mmol/L on the first day in the hospital and experienced significant blood glucose fluctuations in the following three days. After two rounds of clinical pharmacist consultation, the patient's fasting blood glucose (FBG) target was achieved on the seventh day of his hospitalization and was well controlled afterward. The patient's postprandial blood glucose (PBG) target was achieved on the ninth day of hospitalization, and he was discharged when his blood glucose was well controlled and cardiac function had been fully assessed. Hence, we summarize a protocol that could be used to quickly adjust high blood glucose in hospitalized patients and report a new blood glucose management model coordinated by clinical pharmacists and clinicians.
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Affiliation(s)
- Fang-Hong Shi
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Long Shen
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mang-Mang Pan
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lin-Lin Ma
- Institute for Drug Discovery, Griffith University, Brisbanei, Australia
| | - Chi Zhang
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi-Chun Gu
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Ma
- Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Li
- Department of Pharmacy, Clinical Research Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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Ying CZ. Type 2 Diabetes in China - Considering Both Insurance Products and Individual Health Factors. J Insur Med 2020; 48:149-153. [PMID: 32520652 DOI: 10.17849/insm-48-2-1-5.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
For the past 30 years, the increase in the prevalence of type 2 diabetes mellitus (T2DM) in China has reached epidemic proportions. As a result, risk assessment guidelines need to be updated by taking into consideration of improvements in medical treatment and lifestyle intervention. This especially applies to living insurance benefit policies (such as critical illness and total permanent disability) and to medical products (hospitalization reimbursement and certain DM-related treatment benefits). This will require taking into account the current epidemic figures of T2DM in China in pricing, targeting the correct insured group for the DM products and getting the correct risk profile by applying a dynamic underwriting protocol (such as using the rewards for medical intervention, and for primary prevention efforts to screen individuals who are at high-risk of diabetes). This article analyzes both studies and surveys that been conducted in China showing the progress of this epidemic.
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Zhao L, Hao F, Huang J, Liu X, Ma X, Wang C, Bao Y, Wang L, Jia W, Zhao A, Jia W. Sex- and Age-Related Metabolic Characteristics of Serum Free Fatty Acids in Healthy Chinese Adults. J Proteome Res 2020; 19:1383-1391. [PMID: 32096398 DOI: 10.1021/acs.jproteome.9b00502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Free fatty acids (FFAs), also named nonesterified fatty acids, largely originate from the lipolysis of triacylglycerol stored in adipose tissue. Despite extensive research on sex- and age-dependent effects on lipolysis and lipid mobilization of adipose tissue, the primary differences in the metabolic characteristics of circulating FFAs among normal-weight healthy men and women during aging are still unclear. Here, we measured the concentrations of 45 FFAs in fasting sera of two Chinese community-based studies consisting of 201 metabolically healthy normal-weight adults to ascertain the associations of sex and age with FFA compositions and their upstream and downstream relations. Results showed greater conversions toward n-3 polyunsaturated fatty acids of docosahexaenoic acid and n-6 of docosapentaenoic acid from their precursors in women than in men. Meanwhile, there were significantly positive correlations between the concentrations of a panel of saturated fatty acids with straight chain or branched chain and age in women, whereas no association was found in men. These findings highlight that sex and age should be considered as the potential confounding factors in assessing the risk for metabolic disturbance using FFA biomarkers.
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Affiliation(s)
- Linjing Zhao
- College of Chemistry and Chemical Engineering, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Fangjia Hao
- College of Chemistry and Chemical Engineering, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Jiashuai Huang
- College of Chemistry and Chemical Engineering, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Xiaohui Liu
- College of Chemistry and Chemical Engineering, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Xiaojing Ma
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Congrong Wang
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yuqian Bao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Lixin Wang
- Integrated TCM & Western Medicine Department, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200433, China
| | - Weiping Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Aihua Zhao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Wei Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,University of Hawaii Cancer Center, Honolulu, Hawaii 96813, United States
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Bevan G, De Poli C, Keng MJ, Raine R. How valid are projections of the future prevalence of diabetes? Rapid reviews of prevalence-based and Markov chain models and comparisons of different models' projections for England. BMJ Open 2020; 10:e033483. [PMID: 32132137 PMCID: PMC7059487 DOI: 10.1136/bmjopen-2019-033483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To examine validity of prevalence-based models giving projections of prevalence of diabetes in adults, in England and the UK, and of Markov chain models giving estimates of economic impacts of interventions to prevent type 2 diabetes (T2D). METHODS Rapid reviews of both types of models. Estimation of the future prevalence of T2D in England by Markov chain models; and from the trend in the prevalence of diabetes, as reported in the Quality and Outcomes Framework (QOF), estimated by ordinary least squares regression analysis. SETTING Adult population in England and UK. MAIN OUTCOME MEASURE Prevalence of T2D in England and UK in 2025. RESULTS The prevalence-based models reviewed use sample estimates of past prevalence rates by age and sex and projected population changes. Three most recent models, including that of Public Health England (PHE), neither take account of increases in obesity, nor report Confidence Intervals (CIs). The Markov chain models reviewed use transition probabilities between states of risk and death, estimated from various sources. None of their accounts give the full matrix of transition probabilities, and only a minority report tests of validation. Their primary focus is on estimating the ratio of costs to benefits of preventive interventions in those with hyperglycaemia, only one reported estimates of those developing T2D in the absence of a preventive intervention in the general population.Projections of the prevalence of T2D in England in 2025 were (in millions) by PHE, 3.95; from the QOF trend, 4.91 and by two Markov chain models, based on our review, 5.64 and 9.07. CONCLUSIONS To inform national policies on preventing T2D, governments need validated models, designed to use available data, which estimate the scale of incidence of T2D and survival in the general population, with and without preventive interventions.
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Affiliation(s)
- Gwyn Bevan
- Department of Management, London School of Economics and Political Science, London, UK
| | - Chiara De Poli
- Department of Management, London School of Economics and Political Science, London, UK
| | - Mi Jun Keng
- Department of Management, London School of Economics and Political Science, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
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Liu Y, Guo H, Wang Q, Lian D, Yang M, Huang K, Chen J, Xuan Y, Zhang J, Wei Q, Fang S, Xu J, Liu Y, Sun K, Sun Z, Wang B. Use of capillary glucose combined with other non-laboratory examinations to screen for diabetes and prediabetes. Diabet Med 2019; 36:1671-1678. [PMID: 31392737 DOI: 10.1111/dme.14101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2019] [Indexed: 01/19/2023]
Abstract
AIM To evaluate the value and feasibility of capillary glucose assessment, combined with other non-laboratory measures, in screening for diabetes and prediabetes in the community. METHODS In this cross-sectional study, we assessed fasting capillary glucose, fasting plasma glucose, and both capillary glucose and plasma glucose values after 2-h oral glucose tolerance tests in a total of 3736 samples. We determined the optimal threshold of capillary glucose using receiver-operating characteristic curve analysis. The effect of screening methods using capillary glucose combined with other variables, such as age, BMI and waist circumference, was assessed according to area under the receiver-operating characteristic curve. RESULTS There was a strong positive correlation between capillary glucose and venous plasma glucose. The area under the curve for the model using fasting capillary glucose to screen for impaired fasting glucose was 0.722, while that for the model using capillary glucose after a 2-h oral glucose tolerance test to screen for impaired glucose tolerance was 0.916. The area under the curve for the model using fasting capillary glucose to screen for diabetes was 0.835, while that for the model using 2-h oral glucose tolerance test capillary glucose was 0.912. The area under the curve for the model using fasting capillary glucose + 2-h oral glucose tolerance test capillary glucose to screen for diabetes was 0.945. The discriminatory capability of models using capillary glucose was somewhat improved by adding non-laboratory variables. CONCLUSIONS Capillary glucose could be an alternative for screening for diabetes and prediabetes, especially in low-resource areas.
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Affiliation(s)
- Yuxiang Liu
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Haijian Guo
- Integrated Business Management Office, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Qing Wang
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Dashuai Lian
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Man Yang
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Kaiping Huang
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Jianshuang Chen
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yan Xuan
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Jiarong Zhang
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Qiankun Wei
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | | | - Jinshui Xu
- Integrated Business Management Office, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yu Liu
- Centre for Disease Control and Prevention, Jurong, Jiangsu, China
| | - Kaicheng Sun
- Centre for Disease Control and Prevention, Yandu, Jiangsu, China
| | - Zilin Sun
- Department of Endocrinology, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Bei Wang
- Department of Epidemiology and Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
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Huebschmann AG, Huxley RR, Kohrt WM, Zeitler P, Regensteiner JG, Reusch JEB. Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course. Diabetologia 2019; 62:1761-1772. [PMID: 31451872 PMCID: PMC7008947 DOI: 10.1007/s00125-019-4939-5] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
By 2017 estimates, diabetes mellitus affects 425 million people globally; approximately 90-95% of these have type 2 diabetes. This narrative review highlights two domains of sex differences related to the burden of type 2 diabetes across the life span: sex differences in the prevalence and incidence of type 2 diabetes, and sex differences in the cardiovascular burden conferred by type 2 diabetes. In the presence of type 2 diabetes, the difference in the absolute rates of cardiovascular disease (CVD) between men and women lessens, albeit remaining higher in men. Large-scale observational studies suggest that type 2 diabetes confers 25-50% greater excess risk of incident CVD in women compared with men. Physiological and behavioural mechanisms that may underpin both the observed sex differences in the prevalence of type 2 diabetes and the associated cardiovascular burden are discussed in this review. Gender differences in social behavioural norms and disparities in provider-level treatment patterns are also highlighted, but not described in detail. We conclude by discussing research gaps in this area that are worthy of further investigation.
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Affiliation(s)
- Amy G Huebschmann
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Rachel R Huxley
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Wendy M Kohrt
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Philip Zeitler
- Division of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Judith G Regensteiner
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Division of Cardiology, University of Colorado School of Medicine (CU-SOM), Aurora, CO, USA
| | - Jane E B Reusch
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA.
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA.
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Li Y, Zheng X, Liang D, Zhao A, Jia W, Chen T. MCEE 2.0: more options and enhanced performance. Anal Bioanal Chem 2019; 411:5089-5098. [DOI: 10.1007/s00216-019-01874-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/24/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022]
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Shi C, Sun L, Bai R, Wang H, Liu D, Du J. Comparison of a twice daily injection of insulin aspart 50 with insulin aspart 30 in patients with poorly controlled type 2 diabetes. Curr Med Res Opin 2019; 35:1091-1096. [PMID: 30550344 DOI: 10.1080/03007995.2018.1558853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of a twice daily injection of insulin aspart (BIAsp) 30 and BIAsp50 in patients with type 2 diabetes mellitus (T2DM) poorly controlled with oral hypoglycemic agents (OHAs). METHODS In this 12 week prospective, randomized, parallel trial, a total of 80 T2DM patients, 59 ± 10 years old with a disease duration of 9.3 ± 6.6 years and HbA1c >7% despite large doses of metformin and sulfonylurea administration, were randomized to receive BIAsp30 (n = 40) or BIAsp50 (n = 40). The primary endpoint was a change in HbA1c at week 12. RESULTS The changes in HbA1c from baseline were -2.5% ± 1.0% in the BIAsp50 group and -2.5% ± 1.2% in the BIAsp30 group (p = .897). No difference was observed in the rate of HbA1c target achievement (<7.0%) between BIAsp50 (42.5%) and BIAsp30 (32.5%) (p = .495). The change in fasting plasma glucose (FPG) in the BIAsp50 group was lower than that in the BIAsp30 group (p < .001), while the change in two-hour postprandial blood glucose (2hPBG) was higher and blood glucose excursion was lower in the BIAsp50 group than that in the BIAsp30 group (p < .001, p < .001). A significant improvement in HbA1c was observed with BIAsp50 in subgroups with baseline blood glucose excursion >7.8 mmol/L or 2hPBG >17.6 mmol/L compared with BIAsp30. There were no differences in hypoglycemia or body weight between groups. CONCLUSIONS Compared with BIAsp30, BIAsp50 showed greater efficacy in patients with baseline BG excursion >7.8 mmol/L or 2hPBG >17.6 mmol/L as well as good safety for hypoglycemia. CLINICAL TRIAL REGISTRATION ChiCTR-IIR-16008958.
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Affiliation(s)
- Chunhong Shi
- a Department of Endocrinology , The First Affiliated Hospital of Dalian Medical University , Dalian , PR China
| | - Luyan Sun
- a Department of Endocrinology , The First Affiliated Hospital of Dalian Medical University , Dalian , PR China
| | - Ran Bai
- a Department of Endocrinology , The First Affiliated Hospital of Dalian Medical University , Dalian , PR China
| | - Hao Wang
- a Department of Endocrinology , The First Affiliated Hospital of Dalian Medical University , Dalian , PR China
| | - Dan Liu
- a Department of Endocrinology , The First Affiliated Hospital of Dalian Medical University , Dalian , PR China
| | - Jianling Du
- a Department of Endocrinology , The First Affiliated Hospital of Dalian Medical University , Dalian , PR China
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Sun J, Bao G, Cui J, Yasmeen N, Aslam B, Xin H, Shanshan L, Fu P, Baloch Z. The association of diabetes risk score and body mass index with incidence of diabetes among urban and rural adult communities in Qingdao, China. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00740-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Lu J, Ma X, Zhang L, Mo Y, Ying L, Lu W, Zhu W, Bao Y, Zhou J. Glycemic variability assessed by continuous glucose monitoring and the risk of diabetic retinopathy in latent autoimmune diabetes of the adult and type 2 diabetes. J Diabetes Investig 2019; 10:753-759. [PMID: 30306722 PMCID: PMC6497773 DOI: 10.1111/jdi.12957] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/24/2018] [Accepted: 10/08/2018] [Indexed: 12/11/2022] Open
Abstract
AIMS/INTRODUCTION The relationship between glycemic variability (GV) and diabetic complications has gained much interest and remains under debate. Furthermore, the association of GV with diabetic complications has not been examined in latent autoimmune diabetes of the adult (LADA). Therefore, we evaluated the relationships among several metrics of GV with diabetic retinopathy (DR) in patients with LADA and type 2 diabetes mellitus. MATERIALS AND METHODS A total of 192 patients with LADA and 2,927 patients with type 2 diabetes mellitus were enrolled. After continuous glucose monitoring for 72 h, three metrics of GV including standard deviation, coefficient of variation and mean amplitude of glycemic excursions were calculated. DR was assessed by fundus photography performed with a digital non-mydriatic camera. RESULTS The prevalence of DR was 20.3 and 26.4% in LADA and type 2 diabetes mellitus patients (P < 0.001), respectively. Generally, LADA patients had fewer cardiometabolic risk factors than type 2 diabetes mellitus patients, and all GV metrics were significantly higher in LADA than in type 2 diabetes mellitus. In the multivariate logistic regression analysis, no metrics for GV were identified as independent risk factors of DR (standard deviation: P = 0.175; coefficient of variation: P = 0.769; mean amplitude of glycemic excursions: P = 0.388) in LADA. However, the standard deviation was significantly associated with DR (OR 1.15, P = 0.017) in patients with type 2 diabetes mellitus after adjusting for confounders. The independent relationships of coefficient of variation and mean amplitude of glycemic excursions with DR (P = 0.194 and P = 0.251, respectively) did not reach statistical significance in type 2 diabetes mellitus. CONCLUSIONS GV is more strongly associated with DR in type 2 diabetes than in LADA, suggesting that different glucose-lowering strategies should be used for these two types of diabetes.
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Affiliation(s)
- Jingyi Lu
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Xiaojing Ma
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Lei Zhang
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Yifei Mo
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Lingwen Ying
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Wei Lu
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Wei Zhu
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Yuqian Bao
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Jian Zhou
- Shanghai Clinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Key Laboratory of Diabetes MellitusDepartment of Endocrinology and MetabolismShanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
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Wang TT, Wang XM, Zhang XL. Circulating Vascular Cell Adhesion Molecule-1 (VCAM-1) and Intercellular Adhesion Molecule-1 (ICAM-1): Relationship with carotid artery elasticity in patients with impaired glucose regulation (IGR). ANNALES D'ENDOCRINOLOGIE 2019; 80:72-76. [PMID: 30825997 DOI: 10.1016/j.ando.2019.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/17/2018] [Accepted: 01/11/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the relations of circulating adhesion molecule vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) with carotid artery elasticity in patients with impaired glucose regulation (IGR). METHODS A total of 208 subjects were enrolled from January 2013 to March 2014. One hundred forty-eight were IGR patients, and 60 had normal glucose tolerance (NGT). Carotid intima-media thickness (IMT), carotid artery pressure-strain elasticity coefficient (Eρ), stiffness (β), arterial compliance (AC), and pulse wave velocity (PWVβ), as well as blood pressure, body mass index, blood glucose, blood lipids, insulin resistance index, VCAM-1, and ICAM-1 were measured and compared between IGR and NGT patients. RESULTS Eρ, β and PWVβ were significantly higher in the IGR group than in the NGT group (P<0.05), but the IMT showed no significant difference (P>0.05). VCAM-1 and ICAM-1 were significantly higher in the IGR group than in the NGT group (P<0.05). VCAM-1 and ICAM-1 were positively correlated with Eρ, β, and PWVβ and negatively correlated with AC in IGR patients. CONCLUSIONS Changes in carotid artery elasticity and endothelial dysfunction are found in patients with IGR. Early comprehensive intervention should be performed in such IGR populations.
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Affiliation(s)
- Ting-Ting Wang
- Department of Endocrinology, Zaozhuang Municipal Hospital, 277100 Zaozhuang, Shandong, China
| | - Xiao-Mei Wang
- Department of Endocrinology, Zaozhuang Municipal Hospital, 277100 Zaozhuang, Shandong, China
| | - Xiao-Li Zhang
- Department of Blood Supply, Zaozhuang Central Blood Station, No. 44 Wenhuazhong Road Shizhong District, 277100 Zaozhuang, Shandong, China.
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Chen J, Guo H, Yuan S, Qu C, Mao T, Qiu S, Li W, Wang X, Cai M, Sun H, Wang B, Li X, Sun Z. Efficacy of urinary glucose for diabetes screening: a reconsideration. Acta Diabetol 2019; 56:45-53. [PMID: 30159749 DOI: 10.1007/s00592-018-1212-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/09/2018] [Indexed: 12/29/2022]
Abstract
AIMS Previous studies indicated that urinary glucose (UG) had a limited efficacy in diabetes screening. This study was designed to have a re-evaluation of its efficacy, taking into consideration the collection method of urine and the measurement approach for UG among Chinese adults. METHODS This cross-sectional study enrolled a total of 7689 participants without known diabetes, who were fasted and asked to empty bladders before a 75 g glucose loading. Urine was collected 2 h post glucose loading, and UG was measured using quantitative and qualitative approaches. The efficacy of UG in detecting diabetes was assessed by the receiver operating characteristic (ROC) curve. RESULTS The area under the ROC curve was 0.89 for quantitative UG and 0.87 for qualitative UG. Quantitative UG was positively correlated with fasting plasma glucose (FPG) and 2 h plasma glucose (2 h PG) (r = 0.55 and 0.56, respectively, both P < 0.001). Quantitative UG displayed a sensitivity of 82.9% and a specificity of 84.7% in detecting diabetes at the corresponding optimal cutoff of 130 mg. Qualitative UG exhibited a sensitivity of 80.2% and a specificity of 85.6% at the optimal cutoff of glycosuria + 1. In addition, the sensitivity of both quantitative and qualitative UG was significantly higher than that of HbA1c (≥ 6.5%) (P < 0.001) and had a comparable sensitivity to 2 h PG (≥ 11.1 mmol/L) (P = 0.493). CONCLUSIONS UG, either quantitatively or qualitatively measured at 2 h post glucose loading, was effective in diabetes screening. This indicates that UG is a feasible approach for diabetes screening.
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Affiliation(s)
- Juan Chen
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Haijian Guo
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Suixia Yuan
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Chen Qu
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Tao Mao
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Wei Li
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Xiaohang Wang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Min Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Hong Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
- Department of Endocrinology and Metabolism, The first Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Bei Wang
- School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Xiaoning Li
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China.
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Liu L, Guan X, Yuan Z, Zhao M, Li Q, Zhang X, Zhang H, Zheng D, Xu J, Gao L, Guan Q, Zhao J. Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China. J Diabetes Res 2019; 2019:4328975. [PMID: 30949514 PMCID: PMC6425409 DOI: 10.1155/2019/4328975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 11/05/2018] [Indexed: 01/08/2023] Open
Abstract
AIM It is known that different stages of type 2 diabetes represent distinct pathophysiological changes, but how the spectrum of risk factors varies at different stages is not yet clarified. Hence, the aim of this study was to compare the effect of different metabolic variables on the natural history of type 2 diabetes. METHODS A total of 5,213 nondiabetic (normal glucose tolerance (NGT) and prediabetes) Chinese older than 40 years participated this prospective cohort study, and 4,577 completed the 3-year follow-up. Glycemic status was determined by standard oral glucose tolerance test both at enrollment and follow-up visit. Predictors for conversion in glycemic status were studied in a corresponding subcohort using the multiple logistic regression analysis. RESULTS The incidence of prediabetes and diabetes of the cohort was 93.6 and 42.2 per 1,000 person-years, respectively. After a 3-year follow-up, 33.1% of prediabetes patients regressed to NGT. The predictive weight of body mass index (BMI), serum triglyceride, total cholesterol, and systolic blood pressure in different paths of conversions among diabetes, prediabetes, and NGT differed. Specifically, BMI was the strongest predictor for regression from prediabetes to NGT, while triglyceride was most prominent for onset of diabetes. One SD increase in serum triglyceride was associated with a 1.29- (95% CI 1.10-1.52; P = 0.002) or 1.12- (95% CI 1.01-1.27; P = 0.039) fold higher risk of diabetes for individuals with NGT or prediabetes, respectively. CONCLUSION Risk factors for different stages of diabetes differed, suggesting personalized preventive strategies for individuals with different basal glycemic statuses.
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Affiliation(s)
- Lu Liu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
- Department of Senior Officials Health Care, China-Japan Friendship Hospital, 100029, China
| | - Xiaoling Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, 250014, China
| | - Zhongshang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, 250012, China
| | - Meng Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Qiu Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Xu Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Dongmei Zheng
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Jin Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Ling Gao
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
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25
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Chen J, Guo HJ, Qiu SH, Li W, Wang XH, Cai M, Wang B, Li XN, Sun ZL. Identification of Newly Diagnosed Diabetes and Prediabetes Using Fasting Plasma Glucose and Urinary Glucose in a Chinese Population: A Multicenter Cross-Sectional Study. Chin Med J (Engl) 2018; 131:1652-1657. [PMID: 29998883 PMCID: PMC6048922 DOI: 10.4103/0366-6999.235884] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Although fasting plasma glucose (FPG) has been highly recommended as the sole test for diabetes screening, the efficacy of FPG alone for diabetes screening is potentially limited due to its low sensitivity. The aim of this study was to improve the efficacy of FPG for diabetes screening using urinary glucose (UG). Methods This study was initiated on November 12, 2015, and ended on June 28, 2016. A representative sample of individuals aged between 18 and 65 years, with no history of diabetes, from 6 cities in Jiangsu Province participated in this study. A 75-g oral glucose tolerance test was used to diagnose diabetes. All urine samples were collected within 2 h of oral glucose loading to measure UG. Partial correlation analyses were used to evaluate the associations between UG and other glycemic variables, including FPG, 2-h plasma glucose (2h-PG), and glycated hemoglobin A1c, after adjustment for age. The performance of UG was evaluated using a receiver operating characteristic (ROC) curve analysis. Results Of the 7485 individuals included, 8% were newly diagnosed with diabetes and 48.7% had prediabetes. The areas under the ROC curves for UG were 0.75 for estimation of 2h-PG ≥7.8 mmol/L and 0.90 for 2h-PG ≥11.1 mmol/L, respectively. The sensitivity and specificity of UG were 52.3% and 87.8%, respectively, for 2h-PG ≥7.8 mmol/L (cutoff point ≥130 mg), and 83.5% and 87.5%, respectively, for 2h-PG ≥11.1 mmol/L (cutoff point ≥178.5 mg). The combination of FPG and UG demonstrated a significantly higher sensitivity than that of FPG alone for the identification of diabetes ([483/597] 80.9% vs. [335/597] 56.1%, χ2 = 85.0, P < 0.001) and glucose abnormalities ([2643/4242] 62.3% vs. [2365/4242] 55.8%, χ2 = 37.7, P < 0.001). Conclusions The combination of UG and FPG substantially improves the efficacy of using FPG alone for diabetes screening; this combination might be a practical screening tool and is worth being recommended in the future.
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Affiliation(s)
- Juan Chen
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu 210009, China
| | - Hai Jian Guo
- Integrated Business Management Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Shan-Hu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu 210009, China
| | - Wei Li
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu 210009, China
| | - Xiao-Hang Wang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu 210009, China
| | - Min Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu 210009, China
| | - Bei Wang
- Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, China
| | - Xiao-Ning Li
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Zi-Lin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, Jiangsu 210009, China
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26
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Yan J, Jiang F, Zhang R, Xu T, Zhou Z, Ren W, Peng D, Liu Y, Hu C, Jia W. Whole-exome sequencing identifies a novel INS mutation causative of maturity-onset diabetes of the young 10. J Mol Cell Biol 2018; 9:376-383. [PMID: 28992123 DOI: 10.1093/jmcb/mjx039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 08/18/2017] [Indexed: 12/28/2022] Open
Abstract
Monogenic diabetes is often misdiagnosed with type 2 diabetes due to overlapping characteristics. This study aimed to discover novel causative mutations of monogenic diabetes in patients with clinically diagnosed type 2 diabetes and to explore potential molecular mechanisms. Whole-exome sequencing was performed on 31 individuals clinically diagnosed with type 2 diabetes. One novel heterozygous mutation (p.Ala2Thr) in INS was identified. It was further genotyped in an additional case-control population (6523 cases and 4635 controls), and this variant was observed in 0.09% of cases. Intracellular trafficking of insulin proteins was assessed in INS1-E and HEK293T cells. p.Ala2Thr preproinsulin-GFP was markedly retained in the endoplasmic reticulum (ER) in INS1-E cells. Activation of the PERK-eIF2α-ATF4, IRE1α-XBP1, and ATF6 pathways as well as upregulated ER chaperones were detected in INS1-E cells transfected with the p.Ala2Thr mutant. In conclusion, we identified a causative mutation in INS responsible for maturity-onset diabetes of the young 10 (MODY10) in a Chinese population and demonstrated that this mutation affected β cell function by inducing ER stress.
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Affiliation(s)
- Jing Yan
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Feng Jiang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Rong Zhang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Tongfu Xu
- The Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of the Chinese Academy of Sciences, Shanghai, China
| | - Zhou Zhou
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Ren
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Danfeng Peng
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yong Liu
- The Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of the Chinese Academy of Sciences, Shanghai, China
| | - Cheng Hu
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Institute for Metabolic Disease, Fengxian Central Hospital Affiliated to Southern Medical University, Shanghai, China
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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27
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Abstract
The People's Republic of China (herein referred to as China) has witnessed one of the most dramatic rises in diabetes prevalence anywhere in the world. The latest epidemiological study suggests that approximately 11% of the population has diabetes, with a significant proportion remaining undiagnosed. Risk factors for diabetes in the Chinese population are similar to those in other populations, though gestational diabetes and young-onset diabetes is becoming increasingly common. Data on the prevalence of diabetic complications remain limited, though cardio-renal complications account for significant morbidity and mortality. Other diabetes-related comorbidities are becoming increasingly common, with cancer emerging as a major cause of mortality among individuals with diabetes. There are many challenges and obstacles that impede effective diabetes prevention and the delivery of care, though much progress has occurred over recent years. Lessons learnt from how China has responded to the challenges posed by the diabetes epidemic will be invaluable for other countries facing the many threats of diabetes and its complications.
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Affiliation(s)
- Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
- Chinese University of Hong Kong and Shanghai Jiao Tong University (CUHK-SJTU) Joint Research Centre in Diabetes Genomics and Precision Medicine, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
- NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
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28
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Wang T, Zhang R, Ma X, Wang S, He Z, Huang Y, Xu B, Li Y, Zhang H, Jiang F, Bao Y, Hu C, Jia W. Causal Association of Overall Obesity and Abdominal Obesity with Type 2 Diabetes: A Mendelian Randomization Analysis. Obesity (Silver Spring) 2018; 26:934-942. [PMID: 29630776 DOI: 10.1002/oby.22167] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/01/2018] [Accepted: 02/14/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aimed to compare the causal effect of overall obesity and abdominal obesity on type 2 diabetes among Chinese Han individuals. METHODS The causal relationship of BMI and waist-to-hip ratio (WHR) with the risk of glucose deterioration and glycemic traits was compared using two different genetic instruments based on 30 BMI loci and 6 WHR loci with Mendelian randomization (MR) in three prospective cohorts (n = 6,476). RESULTS Each 1-SD genetically instrumented higher WHR was associated with a 65.7% higher risk of glucose deterioration (95% CI = 1.069-2.569, P = 0.024), whereas no significant association of BMI with glucose deterioration was observed. Furthermore, a causal relationship was found only between BMI and homeostatic model assessment β-cell function (HOMA-B) (β = 0.143, P = 0.001), and there was a nominal association with Stumvoll second-phase insulin secretion traits (β = 0.074, P = 0.022). The significance level did not persist in sensitivity analyses, except in the causal estimate of WHR on the Gutt index in MR-Egger (β = -0.379, P = 0.022) and the causal estimate of BMI on homeostatic model assessment β-cell function in weighted median MR (β = 0.128, P = 0.017). CONCLUSIONS The data from this study support the potential causal relationship between abdominal obesity and hyperglycemia, which may be driven by aggravated insulin resistance, in contrast with the potential causal relationship between overall obesity and insulin secretion.
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Affiliation(s)
- Tao Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Rong Zhang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaojing Ma
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shiyun Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhen He
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yeping Huang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Bo Xu
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yangyang Li
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hong Zhang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Feng Jiang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuqian Bao
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Cheng Hu
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Institute for Metabolic Disease, Fengxian Central Hospital Affiliated to Southern Medical University, Shanghai, China
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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29
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Zhao J, Xiong X, Li Y, Liu X, Wang T, Zhang H, Jiao Y, Jiang J, Zhang H, Tang Q, Gao X, Li X, Lu Y, Liu B, Hu C, Li X. Hepatic F-Box Protein FBXW7 Maintains Glucose Homeostasis Through Degradation of Fetuin-A. Diabetes 2018; 67:818-830. [PMID: 29475832 DOI: 10.2337/db17-1348] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/12/2018] [Indexed: 11/13/2022]
Abstract
Type 2 diabetes mellitus (T2DM) has become one of the most serious and long-term threats to human health. However, the molecular mechanism that links obesity to insulin resistance remains largely unknown. Here, we show that F-box and WD repeat domain-containing 7 (FBXW7), an E3 ubiquitin protein ligase, is markedly downregulated in the liver of two obese mouse models and obese human subjects. We further identify a functional low-frequency human FBXW7 coding variant (p.Ala204Thr) in the Chinese population, which is associated with elevated blood glucose and T2DM risk. Notably, mice with liver-specific knockout of FBXW7 develop hyperglycemia, glucose intolerance, and insulin resistance even on a normal chow diet. Conversely, overexpression of FBXW7 in the liver not only prevents the development of high-fat diet-induced insulin resistance but also attenuates the disease signature of obese mice. Mechanistically, FBXW7 directly binds to hepatokine fetuin-A to induce its ubiquitination and subsequent proteasomal degradation, comprising an important mechanism maintaining glucose homeostasis. Thus, we provide evidence showing a beneficial role of FBXW7 in glucose homeostasis.
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Affiliation(s)
- Jiejie Zhao
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuelian Xiong
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yao Li
- Department of Laboratory Animal Science, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xing Liu
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tao Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, and Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Hong Zhang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, and Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Yang Jiao
- Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Jiang
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huijie Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiqun Tang
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xin Gao
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xuejun Li
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yan Lu
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bin Liu
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
- Hubei Key Laboratory for Kidney Disease Pathogenesis and Intervention, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University School of Medicine, Huangshi, Hubei, China
| | - Cheng Hu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, and Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai, China
- Fengxian Central Hospital, Affiliated Hospital of Southern Medical University, Shanghai, China
| | - Xiaoying Li
- Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
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Liang K, Wang C, Yan F, Wang L, He T, Zhang X, Li C, Yang W, Ma Z, Ma A, Hou X, Chen L. HbA1c Cutoff Point of 5.9% Better Identifies High Risk of Progression to Diabetes among Chinese Adults: Results from a Retrospective Cohort Study. J Diabetes Res 2018; 2018:7486493. [PMID: 30009184 PMCID: PMC6020536 DOI: 10.1155/2018/7486493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/14/2018] [Accepted: 04/05/2018] [Indexed: 11/22/2022] Open
Abstract
AIMS This article performed a retrospective cohort study to estimate the annual incidence rates of diabetes and to assess the utility of HbA1c as a predictor for progression to diabetes in Chinese community adults aged 40 years or older. METHODS In all, 2778 nondiabetic subjects (including 1901 women) underwent HbA1c testing and oral glucose tolerance test (OGTT) measurements at baseline and after 3 years. Diabetes and prediabetes were defined using the WHO criteria. The HbA1c cutoff points were evaluated to predict the future risks of diabetes. Relative risk (RR) was calculated using the chi-square test. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive efficiency of fasting plasma glucose (FPG), 2 hr postprandial plasma glucose (2hPG), and HbA1c for progression to diabetes. A superior cutoff point was defined as the point on the ROC curve with a larger Youden index. RESULTS Overall, 7.5% (210/2778) of the subjects progressed to diabetes, yielding an annual 2.5% diabetes incidence rate. Additionally, 4.5% (100/2227) of the subjects with normal glucose tolerance (NGT) and 19.6% (110/561) of the subjects with prediabetes progressed to diabetes, and the relative risk of progression to diabetes was 5.188 times higher in subjects with prediabetes than in subjects with NGT (p < 0.001). Compared to subjects with HbA1c values ≤ 5.6%, the RRs of progression to diabetes in subjects whose HbA1c ranged from 5.7 to 5.8%, 5.9 to 6.2%, 6.3 to 6.4%, and ≥6.5% were 1.165, 2.582, 5.732, and 16.619, respectively. However, the RRs for subjects with HbA1c ranging from 5.7 to 5.8% and those with HbA1c ≤ 5.6% did not differ significantly (p = 0.615). The AUCs for predicting diabetes after 3 years by FPG, 2hPG, and HbA1c were 0.752 (95% confidence interval 0.718-0.787), 0.710 (95% confidence interval 0.671-0.748), and 0.756 (95% confidence interval 0.720-0.793), respectively. The HbA1c cutoff point of 5.9% (sensitivity of 0.771 and specificity of 0.580) may better identify individuals at high risk of progression to diabetes than the 5.7% value (sensitivity of 0.862 and specificity of 0.371) due to the former's larger Youden index of 0.351, which exceeded the indices for FPG and 2hPG. CONCLUSIONS The use of HbA1c values ≥ 5.9% may provide greater accuracy in evaluating the risk of progression to diabetes and identify individuals with prediabetes with greater reliability among Chinese adults.
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Affiliation(s)
- Kai Liang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | - Chuan Wang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | - Fei Yan
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | - Lingshu Wang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | - Tianyi He
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | | | - Chengqiao Li
- Department of Endocrinology, Second People's Hospital, Jining, China
| | | | - Zeqiang Ma
- China National Heavy-Duty Truck Group Corporation Hospital, Jinan, China
| | - Aixia Ma
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | - Xinguo Hou
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
| | - Li Chen
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China
- Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China
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Zhao T, Lin Z, Zhu H, Wang C, Jia W. Impact of body fat percentage change on future diabetes in subjects with normal glucose tolerance. IUBMB Life 2017; 69:947-955. [PMID: 29130609 DOI: 10.1002/iub.1693] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 10/22/2017] [Indexed: 11/11/2022]
Abstract
The aim of the work was to determine the effect of body fat change on risk of diabetes in normal glucose tolerance (NGT) population. A total of 1,857 NGT subjects were included and followed up for an average period of 44.57 months. Body fat percentage (BF%) was measured by bioelectrical impedance analysis. Subjects were grouped based on the BF% and/or body mass index (BMI) state. Among all subjects, 28 developed diabetes after follow-up. Compared with subjects with stable normal BF% (control), subjects who became obesity at follow-up were defects in insulin secretion and had a higher risk of developing diabetes (7.102, 95% confidence intervals [CI] 1.740-28.993), while no difference in diabetic risk could be viewed between subjects with abnormal BF% at baseline but normal at the end of follow-up and control subjects after adjustment of confounding factors. Moreover, compared with those keeping normal BF% and BMI both at baseline and follow-up, subjects who had normal BMI at baseline and follow-up, but abnormal BF% at baseline or/and follow-up still had a higher risk to develop diabetes (4.790, 95% CI 1.061-21.621), while those with normal BF% at baseline and follow-up, but abnormal BMI at baseline or/and follow-up had not. Subjects from normal BF% at baseline to obese at follow-up are associated with an increased risk of diabetes. Maintaining normal body fat is more relevant than BMI in preventing diabetes. © 2017 IUBMB Life, 69(12):947-955, 2017.
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Affiliation(s)
- Tianxue Zhao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Shanghai Diabetes Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People's Republic of China
| | - Ziwei Lin
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Shanghai Diabetes Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People's Republic of China
| | - Hui Zhu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Shanghai Diabetes Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People's Republic of China
| | - Chen Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Shanghai Diabetes Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People's Republic of China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Shanghai Diabetes Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, People's Republic of China
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32
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Diagnostic criteria for diabetes in China: are we pushing too much beyond evidence? Eur J Clin Nutr 2017; 71:812-815. [PMID: 28513625 DOI: 10.1038/ejcn.2017.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/02/2017] [Accepted: 03/08/2017] [Indexed: 12/30/2022]
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Han C, Zhang M, Luo X, Wang C, Yin L, Pang C, Feng T, Ren Y, Wang B, Zhang L, Li L, Yang X, Zhang H, Zhao Y, Zhou J, Xie Z, Zhao J, Hu D. Secular trends in the prevalence of type 2 diabetes in adults in China from 1995 to 2014: A meta-analysis. J Diabetes 2017; 9:450-461. [PMID: 27282985 DOI: 10.1111/1753-0407.12440] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/01/2016] [Accepted: 06/07/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The aim of the present study was to estimate trends in the prevalence of type 2 diabetes mellitus (T2DM) in adults in China. METHODS A systematic search was conducted for studies of T2DM prevalence in adults in China from 2000 to 2014. Pooled prevalence was calculated by a random-effects model. Subgroup and sensitivity analyses were performed. Chi-squared and Cochran-Mantel-Haenszel tests were used to assess differences among subgroups and pooled prevalence, respectively. RESULTS Forty-six studies (data from 1995 to 2014; 1 463 079 adults) were included in the meta-analysis. The overall prevalence of T2DM was 7.9 %. The pooled prevalence overall and by location (urban and rural), gender (male and female), and age category (18-39, 40-59, and ≥60 years) was 4.5 %, 5.1 % and 3.0 %, 4.0 % and 4.2 %, and 1.4 %, 5.0 %, and 10.3 %, respectively, from 1995 to 1999; 6.6 %, 9.3 % and 5.6 %, 7.4 % and 7.5 %, and 1.8 %, 5.9 %, and 12.4 %, respectively, from 2000 to 2004; 10.3 %, 11.8 % and 6.8 %, 10.0 % and 8.6 %, and 2.8 %, 10.3 %, and 20.0 %, respectively, from 2005 to 2009; and 8.3 %, 12.5 % and 7.6 %, 8.6 % and 8.0 %, and 3.5 %, 8.5 %, and 15.3 %, respectively, from 2010 to 2014. The prevalence increased from 5.8 % to 11.6 % with per-capita gross domestic product and differed by diagnostic criteria. CONCLUSIONS There was a trend of increasing prevalence of T2DM in adults in China from 1995 to 2009, with a decrease in 2010-14 and a greater increase over time in urban versus rural areas, males versus females, and older versus younger adults.
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Affiliation(s)
- Chengyi Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Prevention and Health Care, The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiangyu Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongyan Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Zhihui Xie
- Intensive Care Unit, Zhoukou City Central Hospital, Zhoukou, China
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Prevention and Health Care, The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
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Wang Y, Yuan Y, Zhang Y, Lei C, Zhou Y, He J, Sun Z. Serum 1,5-anhydroglucitol level as a screening tool for diabetes mellitus in a community-based population at high risk of diabetes. Acta Diabetol 2017; 54:425-431. [PMID: 27896445 DOI: 10.1007/s00592-016-0944-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/14/2016] [Indexed: 12/12/2022]
Abstract
AIMS Early diagnosis of diabetes yields significant clinical benefits; however, currently available diagnostic tools for community-based population are limited. This study aimed to assess the value of serum 1,5-anhydroglucitol (1,5-AG) for the diagnosis and screening of diabetes mellitus in a community-based population at high risk of diabetes. METHODS In this diagnostic test, 1170 participants underwent a 75-g oral glucose tolerance test. Venous blood samples were collected for fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and glycosylated hemoglobin A1c (HbA1c) measurements. Serum 1,5-AG levels were detected by the GlycoMark assay, and a receiver operating characteristic (ROC) curve was generated to assess their diagnostic value for diabetes. RESULTS A total of 298 adults were diagnosed with diabetes, indicating a prevalence of 25.47%. Partial Pearson correlation analysis adjusted for age and body mass index showed that serum 1,5-AG level was negatively correlated with FBG, PBG, and HbA1c (all P < 0.01). Areas under the curves (AUCs) for serum 1,5-AG, FBG, PBG, and HbA1c in identifying diabetes were 0.920, 0.874, 0.933, and 0.887, respectively. According to the ROC curve, the optimal cutoff value of serum 1,5-AG for diagnosing diabetes was 11.18 μg/ml, which yielded a sensitivity of 92.6% and a specificity of 82.3%, respectively. Comparisons between 1,5-AG and HbA1c showed that both the AUC and sensitivity of 1,5-AG were higher than those of HbA1c (both P < 0.01). CONCLUSIONS Serum 1,5-AG is a simple and effective marker with high sensitivity and specificity for identifying diabetes in populations at high risk of diabetes.
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Affiliation(s)
- Yao Wang
- Department of Endocrinology, Zhongda Hospital Southeast University, Nanjing, China
| | - Yuexing Yuan
- Department of Endocrinology, Zhongda Hospital Southeast University, Nanjing, China
| | - Yanli Zhang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China
| | - Chenghao Lei
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China
| | - Yi Zhou
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China
| | - Jiajia He
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital Southeast University, Nanjing, China.
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China.
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Wu B, Zhang S, Lin H, Mou S. Prevention of renal failure in Chinese patients with newly diagnosed type 2 diabetes: A cost-effectiveness analysis. J Diabetes Investig 2017; 9:152-161. [PMID: 28296280 PMCID: PMC5754528 DOI: 10.1111/jdi.12653] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 02/08/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
Aims/Introduction Diabetic kidney disease (DKD) is the second leading cause (16.4%) of end‐stage renal disease in China. The current study assessed the cost‐effectiveness of preventing DKD in patients with newly diagnosed type 2 diabetes from the Chinese healthcare perspective. Materials and Methods A lifetime Markov decision model was developed according to the disease course of DKD. Patients with newly diagnosed type 2 diabetes might receive treatment according to one of the following three strategies: (i) “do nothing” strategy (control strategy); (ii) treatment with angiotensin‐converting enzyme inhibitors and angiotensin II receptor blockers (universal strategy); (iii) or screening for microalbuminuria followed by angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker treatment (screening strategy). Clinical and utility data were obtained from the published literature. Direct medical costs and resource utilization in the Chinese healthcare setting were considered. Sensitivity analyses were undertaken to test the impact of a range of variables and assumptions on the results. Results Compared with the control strategy, both the screening and universal strategies were cost‐saving options that showed lower costs and better health benefits. The incremental cost‐effectiveness ratio of the universal strategy over the screening strategy was US $30,087 per quality‐adjusted life‐year, which was higher than the cost‐effectiveness threshold of China. The sensitivity analyses showed robust results, except for the probability of developing macroalbuminuria from microalbuminuria. Conclusions Screening for microalbuminuria could be a cost‐saving option for the prevention of DKD in the Chinese setting.
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Affiliation(s)
- Bin Wu
- Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Suhua Zhang
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Houwen Lin
- Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shan Mou
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Dong N, Shi H, Tang X. Plasma homocysteine levels are associated with macular thickness in type 2 diabetes without diabetic macular edema. Int Ophthalmol 2017; 38:737-746. [PMID: 28391536 DOI: 10.1007/s10792-017-0528-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/04/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To explore the relationships between macular thickness and the plasma concentrations of homocysteine, vitamin B12, folate, and other known risk factors for patients with diabetes without diabetic macular edema (DME). METHODS Fasting venous blood samples were collected from 252 subjects (126 relatively healthy subjects with type 2 diabetes without diabetic macular edema and 126 age- and gender-matched controls). Measurement of macular thickness and volume was performed for those subjects using SD-OCT. The plasma concentrations of homocysteine, vitamin B12, folate, and other known risk factors were analyzed in all the patients and controls using multiple linear regression models. RESULTS An increase in the serum levels of homocysteine was present within patients with type 2 diabetes compared to healthy individuals. The mean total plasma homocysteine levels were associated with a greater central subfield macular thickness (CSMT), average macular thickness (AMT), and average macular volume (AMV) in patients with type 2 diabetes without DME, after adjusting for age, sex, duration of diabetes, and HbA1c. Each 1 mmol/L increase in tHcy level was associated with a 6.57 µm greater CSMT (95% confidence interval [CI] 1.78, 11.36), a 4.51 µm greater AMT (95% CI 1.05, 7.98), and a 4.72 mm3 greater AMV (95% CI 1.23, 8.21). CONCLUSIONS Higher homocysteine levels were associated with an increased CSMT, AMT, and AMV in diabetic patients without DME. This link may indicate that patients with type 2 diabetes with increased levels of plasma tHcy are more prone to develop a clinical manifestation of DME.
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Affiliation(s)
- Ning Dong
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Vision Science, Clinical College of Ophthalmology, Tianjin Medical University, 4, Gansu Road, Heping District, Tianjin, 300020, People's Republic of China
| | - Hong Shi
- Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xin Tang
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Vision Science, Clinical College of Ophthalmology, Tianjin Medical University, 4, Gansu Road, Heping District, Tianjin, 300020, People's Republic of China.
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Yang X, Huo F, Liu B, Liu J, Chen T, Li J, Zhu Z, Lv B. Crocin Inhibits Oxidative Stress and Pro-inflammatory Response of Microglial Cells Associated with Diabetic Retinopathy Through the Activation of PI3K/Akt Signaling Pathway. J Mol Neurosci 2017; 61:581-589. [PMID: 28238066 DOI: 10.1007/s12031-017-0899-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/10/2017] [Indexed: 01/24/2023]
Abstract
Diabetic retinopathy (DR) is a serious microvascular complication of diabetes mellitus that is closely associated with the degeneration and loss of retinal ganglion cells (RGCs) caused by diabetic microangiopathy and subsequent oxidative stress and an inflammatory response. Microglial cells are classed as neurogliocytes and play a significant role in neurodegenerative diseases. Over-activated microglial cells may cause neurotoxicity and induce the death and apoptosis of RGCs. Crocin is one of the two most pharmacologically bioactive constituents in saffron. In the present study, we focused on the role of microglial cells in DR, suggesting that DR may cause the over-activation of microglial cells and induce oxidative stress and the release of pro-inflammatory factors. Microglial cells BV-2 and N9 were cultured, and high-glucose (HG) and free fatty acid (FFA) were used to simulate diabetes. The results showed that HG-FFA co-treatment caused the up-regulated expression of CD11b and Iba-1, indicating that BV-2 and N9 cells were over-activated. Moreover, oxidative stress markers and pro-inflammatory factors were significantly enhanced by HG-FFA treatment. We found that crocin prevented the oxidative stress and pro-inflammatory response induced by HG-FFA co-treatment. Moreover, using the PI3K/Akt inhibitor LY294002, we revealed that PI3K/Akt signaling plays a significant role in blocking oxidative stress, suppressing the pro-inflammatory response, and maintaining the neuroprotective effects of crocin. In total, these results provide a new insight into DR and DR-induced oxidative stress and the inflammatory response, which provide a potential therapeutic target for neuronal damage, vision loss, and other DR-induced complications.
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Affiliation(s)
- Xinguang Yang
- Shaanxi Ophthalmic Medical Center, Xi'an No. 4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University, No. 21 Jiefang Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Fuquan Huo
- Department of Physiology and Pathophysiology, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Bei Liu
- Shaanxi Ophthalmic Medical Center, Xi'an No. 4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University, No. 21 Jiefang Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Jing Liu
- Shaanxi Ophthalmic Medical Center, Xi'an No. 4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University, No. 21 Jiefang Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Tao Chen
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Junping Li
- Department of Anatomy, Histology and Embryology, Ningxia Medical University, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Zhongqiao Zhu
- Shaanxi Ophthalmic Medical Center, Xi'an No. 4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University, No. 21 Jiefang Road, Xi'an, Shaanxi, 710004, People's Republic of China.
| | - Bochang Lv
- Shaanxi Ophthalmic Medical Center, Xi'an No. 4 Hospital, Guangren Hospital Affiliated to School of Medicine of Xi'an Jiaotong University, No. 21 Jiefang Road, Xi'an, Shaanxi, 710004, People's Republic of China.
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Gong L, Li R, Ren W, Wang Z, Wang Z, Yang M, Zhang S. The FOXO1 Gene-Obesity Interaction Increases the Risk of Type 2 Diabetes Mellitus in a Chinese Han Population. J Korean Med Sci 2017; 32:264-271. [PMID: 28049237 PMCID: PMC5219992 DOI: 10.3346/jkms.2017.32.2.264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/04/2016] [Indexed: 12/19/2022] Open
Abstract
Here, we aimed to study the effect of the forkhead box O1-insulin receptor substrate 2 (FOXO1-IRS2) gene interaction and the FOXO1 and IRS2 genes-environment interaction for the risk of type 2 diabetes mellitus (T2DM) in a Chinese Han population. We genotyped 7 polymorphism sites of FOXO1 gene and IRS2 gene in 780 unrelated Chinese Han people (474 cases of T2DM, 306 cases of healthy control). The risk of T2DM in individuals with AA genotype for rs7986407 and CC genotype for rs4581585 in FOXO1 gene was 2.092 and 2.57 times higher than that with GG genotype (odds ratio [OR] = 2.092; 95% confidence interval [CI] = 1.178-3.731; P = 0.011) and TT genotype (OR = 2.571; 95% CI = 1.404-4.695; P = 0.002), respectively. The risk of T2DM in individuals with GG genotype for Gly1057Asp in IRS2 gene was 1.42 times higher than that with AA genotype (OR = 1.422; 95% CI = 1.037-1.949; P = 0.029). The other 4 single nucleotide polymorphisms (SNPs) had no significant association with T2DM (P > 0.05). Multifactor dimensionality reduction (MDR) analysis showed that the interaction between SNPs rs7986407 and rs4325426 in FOXO1 gene and waist was the best model confirmed by interaction analysis, closely associating with T2DM. There was an increased risk for T2DM in the case of non-obesity with genotype combined AA/CC, AA/AC or AG/AA for rs7986407 and rs4325426, and obesity with genotype AA for rs7986407 or AA for rs4325426 (OR = 3.976; 95% CI = 1.156-13.675; P value from sign test [P(sign)] = 0.025; P value from permutation test [P(perm)] = 0.000-0.001). Together, this study indicates an association of FOXO1 and IRS2 gene polymorphisms with T2DM in Chinese Han population, supporting FOXO1-obesity interaction as a key factor for the risk of T2DM.
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Affiliation(s)
- Lilin Gong
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Rong Li
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Ren
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zengchan Wang
- Laboratory for Disease and Gene, Key Laboratory of Molecular Biology of Infectious Diseases designated by the Chinese Ministry of Education, Department of Public Health, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhihong Wang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Maosheng Yang
- Laboratory for Disease and Gene, Key Laboratory of Molecular Biology of Infectious Diseases designated by the Chinese Ministry of Education, Department of Public Health, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Laboratory of Disorders Genes and Department of Pharmacology, Jishou University, Jishou, China
| | - Suhua Zhang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Shu H, Gu LN, Men LC, Lu JM. Lixisenatide Improves Glycemic Control in Asian Type 2 Diabetic Patients Inadequately Controlled With Oral Antidiabetic Drugs: An Individual Patient Data Meta-Analysis. Diabetes Ther 2016; 7:777-792. [PMID: 27796905 PMCID: PMC5118245 DOI: 10.1007/s13300-016-0207-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Lixisenatide is a novel GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus (T2DM). Its efficacy and safety have been assessed in a series of phase 3 studies included in the GetGoal program. In these studies, lixisenatide was found to be superior to placebo in glycemic control. The aim of this meta-analysis was to assess the safety and efficacy of lixisenatide as an adjunct therapy in Asian patients with T2DM in adequately controlled with oral antidiabetic drugs (OADs). METHODS We performed a meta-analysis from five lixisenatide phase 3 studies. In each of these multiethnic studies, patients with T2DM inadequately controlled (glycated hemoglobin, HbA1c ≥7%) with established OADs were randomized to lixisenatide or placebo for 24 weeks, with a balanced distribution of Asian patients in these two arms (503 and 338 patients in the intent-to-treat population, respectively). RESULTS Lixisenatide was superior to placebo in reducing HbA1c (weighted, total mean difference -0.57%; P = 0.002). More patients treated with lixisenatide versus placebo achieved HbA1c targets of ≤7% (49.1% vs. 28.4%, P = 0.003). Lixisenatide was superior to placebo in lowering 2-h postprandial glucose (PPG) (weighted, total mean difference -5.50 mmol/l, P = 0.0005). More patients treated with lixisenatide versus placebo achieved 2-h PPG targets of ≤7.8 mmol/l (39.2% vs. 2.2%, P < 0.0001). More patients treated with lixisenatide versus placebo achieved both an HbA1c target of ≤7% and a 2-h PPG target of ≤10 mmol/l (34.8% vs. 2.69%, P < 0.00001). The body weight of the lixisenatide group tended to decrease. Lixisenatide was generally well tolerated. CONCLUSION Lixisenatide as an adjunct therapy can significantly improve the glycemic control of Asian patients with type 2 DM who do not meet targets for glycemic control with an established OAD regimen. FUNDING Sanofi (China) Investment Co., Ltd., Shanghai, China.
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Affiliation(s)
- Hua Shu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, China
| | - Li-Na Gu
- Sanofi (China) Investment Co., Ltd., 19F Tower III Kerry Center, 1228 Middle Yan'an Road, Shanghai, China
| | - Li-Chuang Men
- Sanofi (China) Investment Co., Ltd., 19F Tower III Kerry Center, 1228 Middle Yan'an Road, Shanghai, China
| | - Ju-Ming Lu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, China.
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Wang S, Ma W, Yuan Z, Wang SM, Yi X, Jia H, Xue F. Association between obesity indices and type 2 diabetes mellitus among middle-aged and elderly people in Jinan, China: a cross-sectional study. BMJ Open 2016; 6:e012742. [PMID: 27810975 PMCID: PMC5129047 DOI: 10.1136/bmjopen-2016-012742] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The relationship between obesity and type 2 diabetes mellitus (T2DM) varies with geographical area and race. OBJECTIVES To investigate the prevalence of T2DM and the proportion of subjects with undiagnosed T2DM. In addition, to compare the associations between different obesity indices and T2DM for middle-aged and elderly people from six communities in Jinan, China. SETTING A cross-sectional study was designed and the study subjects were chosen from blocks which were randomly selected in the 6 communities of Jinan, China in 2011-2012. PARTICIPANTS A total of 3277 residents aged ≥50 years were eligible for this study, but 1563 people were excluded because they did not provide anthropometric data such as height, weight, waist circumference (WC), hip circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, triglyceride (TG), total cholesterol (TC) or information about their current medication use. Hence, 1714 participants were included in the final data analysis. RESULTS The prevalence of T2DM among people aged ≥50 years was 16.6% (19.3% for men and 15.3% for women) and the proportion of patients with undiagnosed T2DM was 32.7%. Compared with the lowest levels of body mass index (BMI), WC, waist-to-hip ratio or waist-to-stature ratio (WSR), the ORs and 95% CIs of the highest levels for men, after adjusting for age, smoking, alcohol drinking, regular exercise, hypertension, TG and TC, were 1.607 (0.804 to 3.210), 2.189 (1.118 to 4.285), 1.873 (0.968 to 3.623) and 2.572 (1.301 to 5.083), respectively, and for women, 2.764 (1.622 to 4.712), 2.407 (1.455 to 3.985), 2.500 (1.484 to 4.211) and 2.452 (1.447 to 4.155), respectively. CONCLUSIONS Among adults aged ≥50 years in Jinan, China, the best indicator of the relationship between obesity and T2DM is WSR for men and BMI for women, respectively.
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Affiliation(s)
- Shukang Wang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Shu-mei Wang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiangren Yi
- The College of Physical Education, Shandong University, Jinan, China
| | - Hongying Jia
- The Second Hospital of Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
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Training Cambodian Village Health Support Guides in Diabetes Prevention: Effects on Guides' Knowledge and Teaching Activities Over 6 Months. Int J Behav Med 2016; 23:162-7. [PMID: 26438042 DOI: 10.1007/s12529-015-9515-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Type 2 diabetes is a pressing public health concern in Cambodia, a country with limited human resource capacity due to genocide. Cambodian village health support guides (Guides) promote health at the local level. PURPOSE This paper reports preliminary results of training Guides in diabetes prevention. METHOD The curriculum, called Eat, Walk, Sleep was delivered to Guides in Siem Reap province once over 3 h. Participants completed a pretest and posttest on diabetes knowledge. Guides were offered continuing education through Eat, Walk, Sleep resources and were encouraged to teach Eat, Walk, Sleep in their villages. For each of 6 months following their training, Guides completed a checklist regarding their activities. RESULTS One hundred eighty-five Guides attended one of ten trainings. Knowledge scores increased significantly from pretest to posttest. During 6 months of follow-up, n = 159 Guides (85 %) completed at least one monthly checklist. Guides reported high rates of uptake and delivery of the Eat, Walk, Sleep curriculum and moderate rates of continuing education about diabetes. CONCLUSION Diabetes prevention in Cambodia is nascent. Guides show excellent uptake and dissemination of the curriculum. Future research should examine effect of support for Guide activities and the effect of the curriculum on villager health behaviors, and ultimately, on rates of type 2 diabetes.
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Mensah KB, Ansah C. Irrational use of antibiotics and the risk of diabetes in Ghana. Ghana Med J 2016; 50:107-14. [PMID: 27635099 DOI: 10.4314/gmj.v50i2.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
UNLABELLED Epidemiological studies show clearly that Caesarean birth, perinatal or neonatal irrational antibiotic use is strongly associated with increased risk of obesity and diabetes in later life. Irrational use of antibiotics is a great global public health concern especially in developing economies like Ghana due to poor regulation on medicines. Unfortunately, this concern has been reduced to the fear of development of resistant organisms and the destruction of the world's limited range of antibiotics therapy at the expense of other insidious risks including the development of metabolic and atopic diseases. These risks however appear to have greater implications on public health systems of developing economies. Here, we review the ignored role of antibiotics in the global obesity pandemic and project the risk that it poses to the health system of a developing economy like Ghana. FUNDING Department of Pharmacology, College of Health Sciences, Kwame Nkrumah university of Science and Technology, Kumasi, Ghana.
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Affiliation(s)
- Kwesi B Mensah
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Ansah
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Chen T, Zheng X, Ma X, Bao Y, Ni Y, Hu C, Rajani C, Huang F, Zhao A, Jia W, Jia W. Tryptophan Predicts the Risk for Future Type 2 Diabetes. PLoS One 2016; 11:e0162192. [PMID: 27598004 PMCID: PMC5012675 DOI: 10.1371/journal.pone.0162192] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/18/2016] [Indexed: 12/12/2022] Open
Abstract
Recently, 5 amino acids were identified and verified as important metabolites highly associated with type 2 diabetes (T2D) development. This report aims to assess the association of tryptophan with the development of T2D and to evaluate its performance with existing amino acid markers. A total of 213 participants selected from a ten-year longitudinal Shanghai Diabetes Study (SHDS) were examined in two ways: 1) 51 subjects who developed diabetes and 162 individuals who remained metabolically healthy in 10 years; 2) the same 51 future diabetes and 23 strictly matched ones selected from the 162 healthy individuals. Baseline fasting serum tryptophan concentrations were quantitatively measured using ultra-performance liquid chromatography triple quadruple mass spectrometry. First, serum tryptophan level was found significantly higher in future T2D and was positively and independently associated with diabetes onset risk. Patients with higher tryptophan level tended to present higher degree of insulin resistance and secretion, triglyceride and blood pressure. Second, the prediction potential of tryptophan is non-inferior to the 5 existing amino acids. The predictive performance of the combined score improved after taking tryptophan into account. Our findings unveiled the potential of tryptophan as a new marker associated with diabetes risk in Chinese populations. The addition of tryptophan provided complementary value to the existing amino acid predictors.
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Affiliation(s)
- Tianlu Chen
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaojiao Zheng
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai, China
| | - Yan Ni
- University of Hawaii Cancer Center, Honolulu, United States of America
| | - Cheng Hu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai, China
| | - Cynthia Rajani
- University of Hawaii Cancer Center, Honolulu, United States of America
| | - Fengjie Huang
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Aihua Zhao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Weiping Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai, China
| | - Wei Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,University of Hawaii Cancer Center, Honolulu, United States of America
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Yan ZP, Ma JX. Risk factors for diabetic retinopathy in northern Chinese patients with type 2 diabetes mellitus. Int J Ophthalmol 2016; 9:1194-9. [PMID: 27588275 DOI: 10.18240/ijo.2016.08.17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 09/01/2015] [Indexed: 12/29/2022] Open
Abstract
AIM To investigate the prevalence and risk factors of diabetic retinopathy (DR) in northern Chinese patients with type 2 diabetes mellitus (T2DM). METHODS This retrospective cross-sectional study was performed between May 2011 and April 2012. A total of 1100 patients (male/female, 483/617) were included in this study. DR was defined following the Early Treatment Diabetic Retinopathy Study (ETDRS) severity scale. All included patients accepted a comprehensive ophthalmic examination including retinal photographs. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) after adjusting for age and gender. RESULTS Retinopathy was present in 307 patients with a prevalence of 27.9%. In univariate logistic analysis, presence of DR was associated with longer duration of diabetes (OR, 5.70; 95%CI, 2.91-12.56), higher concentration of fasting blood glucose (OR, 12.94; 95%CI, 2.40-67.71), higher level of glycosylated hemoglobin HbA1c (OR, 5.50; 95%CI, 3.78-11.97) and insulin treatment (OR, 6.99; 95%CI, 1.39-35.12). The lifestyle of patients with T2DM including smoking, alcohol consumption and regular exercise seemed not associated with the development of DR. CONCLUSION Our study suggests that fasting serum glucose concentration, HbA1c level, duration of diabetes and insulin treatment are potential risk factors for DR in northern Chinese patients with T2DM, while the lifestyle of included patients seems not associated with DR.
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Affiliation(s)
- Zhi-Peng Yan
- Department of Ophthalmology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
| | - Jing-Xue Ma
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Lu J, Luo Y, Wang J, Hu C, Zhang R, Wang C, Jia W. Association of type 2 diabetes susceptibility loci with peripheral nerve function in a Chinese population with diabetes. J Diabetes Investig 2016; 8:115-120. [PMID: 27253191 PMCID: PMC5217885 DOI: 10.1111/jdi.12546] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/18/2016] [Accepted: 06/01/2016] [Indexed: 12/17/2022] Open
Abstract
Aims/Introduction Previous studies have suggested a possible relationship between type 2 diabetes mellitus susceptibility loci and diabetic complications. The present study aimed to investigate the associations between type 2 diabetes mellitus loci with peripheral nerve function in a Chinese population with type 2 diabetes mellitus. Materials and Methods A total of 1,900 type 2 diabetes mellitus patients were recruited in the study. We selected ten single nucleotide polymorphisms (SNPs) from ten type 2 diabetes mellitus susceptibility genes previously confirmed in Chinese patients. Genotyping was carried out by using a MassARRAY Compact Analyzer. Peripheral nerve function was evaluated by nerve conduction studies in all participants. The composite Z‐scores for nerve conduction parameters including conduction velocity (CV), amplitude and latency were calculated, respectively. Results Rs5219 of KCNJ11 (E23K, G→A) was identified to be associated with all the parameters obtained from nerve conduction studies (Z‐score of CV: β = 0.113, P = 0.01; Z‐score of amplitude: β = 0.133, P = 0.01; Z‐score of latency: β = −0.116, P = 0.01) after adjustment for covariates including age, duration and glycated hemoglobin. Specifically, each copy of the A allele was related to better outcomes. CDKAL1 rs7756992 and TCF7L2 rs7903146 correlated with the composite Z‐score of amplitude (P = 0.028 and P = 0.016, respectively), but not CV (P = 0.393 and P = 0.281, respectively) or latency (P = 0.286 and P = 0.273, respectively). There were no significant associations between the other seven SNPs and peripheral nerve function. Conclusions Rs5219 at KCNJ11 (E23K) was associated with peripheral nerve function in a Chinese population with type 2 diabetes mellitus, suggesting shared genetic factors for type 2 diabetes mellitus and diabetic polyneuropathy in this population.
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Affiliation(s)
- Jingyi Lu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Yi Luo
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Jie Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Cheng Hu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Rong Zhang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Congrong Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Diabetes Institute, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.,Shanghai Clinical Center for Diabetes, Shanghai, China
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Weng J, Ji L, Jia W, Lu J, Zhou Z, Zou D, Zhu D, Chen L, Chen L, Guo L, Guo X, Ji Q, Li Q, Li X, Liu J, Ran X, Shan Z, Shi L, Song G, Yang L, Yang Y, Yang W. Standards of care for type 2 diabetes in China. Diabetes Metab Res Rev 2016; 32:442-58. [PMID: 27464265 PMCID: PMC5108436 DOI: 10.1002/dmrr.2827] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 05/11/2016] [Accepted: 06/09/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Jianping Weng
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Linong Ji
- Department of Endocrinology, Peking University People's Hospital, Beijing, China
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Juming Lu
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhiguang Zhou
- Institute of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital and the Diabetes Center, Central South University, Changsha, China
| | - Dajin Zou
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Dalong Zhu
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Liming Chen
- Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Li Chen
- Department of Endocrinology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, Beijing, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Qifu Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoying Li
- Department of Endocrinology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Liu
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Xingwu Ran
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongyan Shan
- Department of Endocrinology, The First Hospital of China Medical University, Shenyang, China
| | - Lixin Shi
- Department of Endocrinology, Affiliated Hospital of Guiyang Medical University, Guiyang, China
| | - Guangyao Song
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Liyong Yang
- Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuzhi Yang
- Department of Endocrinology, Heilongjiang Provincial Hospital, Harbin, China
| | - Wenying Yang
- Department of Endocrinology, China Japan Friendship Hospital, Beijing, China
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A panel of free fatty acid ratios to predict the development of metabolic abnormalities in healthy obese individuals. Sci Rep 2016; 6:28418. [PMID: 27344992 PMCID: PMC4921829 DOI: 10.1038/srep28418] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/31/2016] [Indexed: 01/14/2023] Open
Abstract
Increasing evidences support that metabolically healthy obese (MHO) is a transient state. However, little is known about the early markers associated with the development of metabolic abnormalities in MHO individuals. Serum free fatty acids (FFAs) profile is highlighted in its association with obesity-related insulin resistance, type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). To examine the association of endogenous fatty acid metabolism with future development of metabolic abnormalities in MHO individuals, we retrospectively analyzed 24 [product FFA]/[precursor FFA] ratios in fasting sera and clinical data from 481 individuals who participated in three independent studies, including 131 metabolic healthy subjects who completed the 10-year longitudinal Shanghai Diabetes Study (SHDS), 312 subjects cross-sectionally sampled from the Shanghai Obesity Study (SHOS), and 38 subjects who completed an 8-week very low carbohydrate diet (VLCD) intervention study. Results showed that higher baseline level of oleic acid/stearic acid (OA/SA), and lower levels of stearic acid/palmitic acid (SA/PA) and arachidonic acid/dihomo-γ-linolenic acid (AA/DGLA) ratios were associated with higher rate of MHO to MUO conversion in the longitudinal SHDS. Further, the finding was validated in the cross-sectional and interventional studies. This panel of FFA ratios could be used for identification and early intervention of at-risk obese individuals.
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Li SW, Wang J, Yang Y, Liu ZJ, Cheng L, Liu HY, Ma P, Luo W, Liu SM. Polymorphisms in FADS1 and FADS2 alter plasma fatty acids and desaturase levels in type 2 diabetic patients with coronary artery disease. J Transl Med 2016; 14:79. [PMID: 27004414 PMCID: PMC4802592 DOI: 10.1186/s12967-016-0834-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/15/2016] [Indexed: 12/31/2022] Open
Abstract
Background To explore whether plasma fatty acids and SNPs in the fatty acid desaturase (FADS) gene associated with type 2 diabetes (T2D) and coronary artery disease (CAD). Methods In this cross-sectional study, we utilized gas chromatography–mass spectrometric analysis and the high-resolution melting method to detect plasma fatty acids and SNPs respectively (rs174537G>T, rs174616C>T, rs174460T>C, and rs174450A>C) in 234 T2D, 200 CAD, 185 T2D&CAD patients, and 253 healthy controls. Results We found that T2D&CAD patients had the highest plasma arachidonic acid, dihomo-gamma-linolenic acid and delta-6 desaturase, and the lowest stearic acid, linolenic acid, and saturated fatty acids; plasma eicosapentaenoic acid and docosahexaenoic acid elevated in T2D patients, but significantly reduced in CAD patients. Moreover, T2D patients with rs174537 GG genotype were at risk of developing T2D&CAD (odds ratio (OR) 1.763; 95 % CI 1.143–2.718; p = 0.010), with elevated plasma LDL-cholesterol, arachidonic acid, and delta-6 desaturase. Conclusions Our results show that SNPs in FADS gene (particularly rs174537) associate with plasma fatty acids and desaturase levels in patients with both T2D and CAD, which maybe increases the risk of CAD in diabetic patients. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0834-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Si-Wei Li
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Donghu Road 169#, Wuhan, 430071, People's Republic of China
| | - Jin Wang
- Scientific Research Center, Shanghai Public Health Clinical Center, 2901 Caolang Road, Jinshan District, Shanghai, 201508, People's Republic of China
| | - Ying Yang
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Donghu Road 169#, Wuhan, 430071, People's Republic of China
| | - Zhi-Jie Liu
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery (Wuhan University), Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan, 430072, People's Republic of China
| | - Lin Cheng
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery (Wuhan University), Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan, 430072, People's Republic of China
| | - Huan-Yu Liu
- Department of Clinical Medicine, Hubei University of Medicine, Hubei, 442000, China
| | - Pei Ma
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Donghu Road 169#, Wuhan, 430071, People's Republic of China
| | - Wan Luo
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Donghu Road 169#, Wuhan, 430071, People's Republic of China
| | - Song-Mei Liu
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Donghu Road 169#, Wuhan, 430071, People's Republic of China.
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49
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Branched-chain and aromatic amino acid profiles and diabetes risk in Chinese populations. Sci Rep 2016; 6:20594. [PMID: 26846565 PMCID: PMC4742847 DOI: 10.1038/srep20594] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/07/2016] [Indexed: 12/12/2022] Open
Abstract
Recent studies revealed strong evidence that branched-chain and aromatic amino acids (BCAAs and AAAs) are closely associated with the risk of developing type 2 diabetes in several Western countries. The aim of this study was to evaluate the potential role of BCAAs and AAAs in predicting the diabetes development in Chinese populations. The serum levels of valine, leucine, isoleucine, tyrosine, and phenylalanine were measured in a longitudinal and a cross sectional studies with a total of 429 Chinese participants at different stages of diabetes development, using an ultra-performance liquid chromatography triple quadruple mass spectrometry platform. The alterations of the five AAs in Chinese populations are well in accordance with previous reports. Early elevation of the five AAs and their combined score was closely associated with future development of diabetes, suggesting an important role of these metabolites as early markers of diabetes. On the other hand, the five AAs were not as good as existing clinical markers in differentiating diabetic patients from their healthy counterparts. Our findings verified the close correlation of BCAAs and AAAs with insulin resistance and future development of diabetes in Chinese populations and highlighted the predictive value of these markers for future development of diabetes.
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50
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Zhao Y, Crimmins EM, Hu P, Shen Y, Smith JP, Strauss J, Wang Y, Zhang Y. Prevalence, diagnosis, and management of diabetes mellitus among older Chinese: results from the China Health and Retirement Longitudinal Study. Int J Public Health 2016; 61:347-56. [PMID: 26755457 DOI: 10.1007/s00038-015-0780-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 11/19/2015] [Accepted: 12/18/2015] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To estimate prevalence of diabetes mellitus (DM), success in diagnosing, and methods of diabetes management in China. METHODS China Health and Retirement Longitudinal Study, a representative survey of the Chinese population at least 45 years old, is used to estimate diabetes and prediabetes prevalence, diagnosis, and treatment and their associations with residence, socioe-conomic, and demographic factors. RESULTS Almost 60 % of middle-aged and elderly Chinese have prediabetes or diabetes in 2011-2012. DM prevalence increases with age, but the oldest group is least likely to be diagnosed. Prevalence is higher with higher body mass index, fasting cholesterol, and larger waist circumference. Higher prevalence is found in urban areas among residents with urban registration status (the Chinese administrative registration system or hukou), especially in coastal regions. Better rates of diagnosis, management, and education regarding diabetes are strongly associated with urban hukou, living in coastal areas, and in families with higher per capita expenditures, the appropriate economic resources measure in China. CONCLUSIONS Diagnosis and management of diabetes is highly differential within China but recent efforts to improve health systems are succeeding in reducing undiagnosed disease. Current high prevalence of prediabetes suggests a more intensive effort is required in the future.
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Affiliation(s)
- Yaohui Zhao
- National School of Development, Peking University, Beijing, China.
| | - Eileen M Crimmins
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Peifeng Hu
- UCLA Division of Geriatric Medicine, Los Angeles, CA, USA
| | - Yang Shen
- UCLA Division of Endocrinology, Diabetes and Hypertension, Los Angeles, CA, USA
| | | | - John Strauss
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Yafeng Wang
- Institute for Social Science Survey, Peking University, Beijing, China
| | - Yuan Zhang
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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