1
|
Wei J, Ou Y, Chen J, Yu Z, Wang Z, Wang K, Yang D, Gao Y, Liu Y, Liu J, Zheng X. Mapping global new-onset, worsening, and resolution of diabetes following partial pancreatectomy: a systematic review and meta-analysis. Int J Surg 2024; 110:1770-1780. [PMID: 38126341 PMCID: PMC10942179 DOI: 10.1097/js9.0000000000000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIMS Partial pancreatectomy, commonly used for chronic pancreatitis, or pancreatic lesions, has diverse impacts on endocrine and metabolism system. The study aims to determine the global prevalence of new-onset, worsening, and resolution of diabetes following partial pancreatectomy. METHODS The authors searched PubMed, Embase, Web of Science, and Cochrane Library from inception to October, 2023. DerSimonian-Laird random-effects model with Logit transformation was used. Sensitivity analysis, meta-regression, and subgroup analysis were employed to investigate determinants of the prevalence of new-onset diabetes. RESULTS A total of 82 studies involving 13 257 patients were included. The overall prevalence of new-onset diabetes after partial pancreatectomy was 17.1%. Univariate meta-regression indicated that study size was the cause of heterogeneity. Multivariable analysis suggested that income of country or area had the highest predictor importance (49.7%). For subgroup analysis, the prevalence of new-onset diabetes varied from 7.6% (France, 95% CI: 4.3-13.0) to 38.0% (UK, 95% CI: 28.2-48.8, P <0.01) across different countries. Patients with surgical indications for chronic pancreatitis exhibited a higher prevalence (30.7%, 95% CI: 21.8-41.3) than those with pancreatic lesions (16.4%, 95% CI: 14.3-18.7, P <0.01). The type of surgical procedure also influenced the prevalence, with distal pancreatectomy having the highest prevalence (23.7%, 95% CI: 22.2-25.3, P <0.01). Moreover, the prevalence of worsening and resolution of preoperative diabetes was 41.1 and 25.8%, respectively. CONCLUSIONS Postoperative diabetes has a relatively high prevalence in patients undergoing partial pancreatectomy, which calls for attention and dedicated action from primary care physicians, specialists, and health policy makers alike.
Collapse
Affiliation(s)
- Junlun Wei
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Yiran Ou
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Jiaoting Chen
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Zhicheng Yu
- Department of Economics, Keio University, Minato city, Tokyo, Japan
| | - Zhenghao Wang
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Ke Wang
- Department of Vascular Surgery, University Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Dujiang Yang
- Department of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan University
| | - Yun Gao
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Yong Liu
- Department of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan University
| | - Jiaye Liu
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-Related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province
- Laboratory of Thyroid and Parathyroid diseases, Frontiers Science Center for Disease-Related Molecular Network
- Department of General Surgery, Division of Thyroid Surgery, West China Hospital, Sichuan University
| | - Xiaofeng Zheng
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| |
Collapse
|
2
|
Dipeptidyl peptidase-4 inhibitors reduced long-term cardiovascular risk in diabetic patients after percutaneous coronary intervention via insulin-like growth factor-1 axis. Sci Rep 2022; 12:5129. [PMID: 35332212 PMCID: PMC8948237 DOI: 10.1038/s41598-022-09059-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/11/2022] [Indexed: 12/11/2022] Open
Abstract
Dipeptidyl-peptidase-4 inhibitors (DPP4i) have been the most used antidiabetic medications worldwide due to their good safety profiles and tolerability with a low risk of hypoglycemia, however, large cardiovascular outcome trials (CVOTs) have not shown any significant the prognostic superiority. On the contrary, since observational studies have suggested the effects of DPP4i are enhanced some populations, such as Asians and those who without overweight, their prognostic benefit is still under debate. The aim of this study was thus to assess the prognostic impact of DPP4i in patients with both diabetes and coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI) through the insulin-like growth factor-1 (IGF-1) axis, a substrate of DPP4. This single-center analysis involved consecutive Japanese diabetic patients who underwent PCI for the first time between 2008 and 2018 (n = 885). Primary and secondary endpoints were set as cardiovascular (CV) death and the composite of CV death, non-fatal myocardial infarction and ischemic stroke (3P-MACE). Serum levels of IGF-1 and its main binding protein (insulin-like growth factor binding protein-3: IGFBP-3) were measured. In consequences, unadjusted Kaplan–Meier analyses revealed reduced incidences of CV-death and 3P-MACE by DPP4i, which was particularly enhanced in patients who were not overweight (BMI ≤ 25). Multivariate Cox hazard analyses consistently indicated reduced risks of CV death by DPP4i at PCI (hazard ratio (HR) 0.39, 95% confidence interval (CI) 0.16–0.82, p = 0.01) and 3P-MACE (HR 0.47, 95% CI 0.25–0.84, p = 0.01), respectively. Moreover, elevated IGF-1 activity indicated by the IGF-1/IGFBP-3 ratio was associated with decreased risks of both endpoints and it was significantly higher in patients with DPP4i (p < 0.0001). In conclusion, the findings of the present study indicate beneficial effects of DPP4i to improve outcomes in Japanese diabetic patients following PCI, which might be mediated by DPP4–IGF-1 axis.
Collapse
|
3
|
Sun Y, Han J, Lin Z, Song L, Wang C, Jia W. Delayed insulin secretion response during an OGTT is associated with an increased risk for incidence of diabetes in NGT subjects. J Diabetes Complications 2016; 30:1537-1543. [PMID: 27568916 DOI: 10.1016/j.jdiacomp.2016.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/14/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
AIMS This study aimed to assess whether insulin secretion patterns during oral glucose tolerance tests (OGTTs) could predict future type 2 diabetes (T2D) in Chinese normal glucose tolerance (NGT) subjects. METHODS A total of 558 NGT, 419 newly diagnosed impaired glucose tolerance, and 694 newly diagnosed T2D patients were assessed. NGT subjects were grouped based on the time of peak insulin secretion during a 3h- OGTT; at 30min (InsP30), 60min (InsP60), 120min (InsP120), or 180min (InsP180), respectively. NGT subjects were followed up for an average duration of 5.58±1.08years. Beta-cell function was estimated by Stumvoll insulin secretion. RESULTS The InsP120 and InsP180 groups had lower Stumvoll first-phase insulin secretion levels compared with InsP30. At 5.58±1.08years, 25 (5.39%) NGT subjects had developed T2D. The cumulative incidence rate of diabetes was higher in the InsP120 and InsP180 groups (8.94%), compared with InsP30 (1.48%) (P<0.05). The adjusted relative risk for incident diabetes was 7.30 (95% CI: 1.53-34.72) times higher in the InsP120 and InsP180 groups. CONCLUSIONS NGT subjects with late insulin responses had defective early insulin secretion and were at higher risk of developing diabetes. Insulin secretion patterns could be a useful T2D predictor in the Chinese population.
Collapse
Affiliation(s)
- Yun Sun
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Junfeng Han
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Ziwei Lin
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Lige Song
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| | - Chen Wang
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China.
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P.R. China
| |
Collapse
|
4
|
Abstract
OBJECTIVE To review trends in the prevalence and incidence of diabetes mellitus (DM) and related risk factors in China. METHODS We searched the literature using PubMed, China Knowledge Resource Integrated Database, and China Wanfang Digital Database for large epidemiologic studies and national surveys. RESULTS During the past 30 years (1980-2010), 7 national diabetes mellitus surveys were conducted in China mainland, indicating that the prevalence of DM has increased 17-fold, from 0.67 to 11.6% of the population. The prevalence of impaired glucose regulation (IGR, including impaired fasting glucose and impaired glucose tolerance) also increased, from 2.09 in 1994 to 27.2% in 2010. There was no national representative study of the incidence of diabetes to date; the reported incidence of type 2 diabetes during past 25 years in several cohort studies varied (2.7 to 15.8 per 1,000 person-years). Potential risk factors which could have contributed to the increasing prevalence and incidence of DM and IGR in the Chinese population include social and economic development, urbanization, dietary pattern, and Westernized lifestyle. Further, genetic studies have suggested that unique inheritable risk factors in the Chinese population may increase the risk for DM when compared to Caucasians. CONCLUSION DM and IGR have become epidemic in China. Public health strategies should focus on modifying lifestyle and dietary factors, particularly among those with a susceptible genetic background. ABBREVIATIONS BMI = body mass index DM = diabetes mellitus FBG = fasting blood glucose GWAS = genome-wide association study IGR = impaired glucose regulation IGT = impaired glucose tolerance OGTT = oral glucose tolerance test T2D = type 2 diabetes WC = waist circumference WHR = waist-hip ratio.
Collapse
Affiliation(s)
- Xiuhua Shen
- Department of Clinical Nutrition, Shanghai Xin Hua Hospital, Shanghai, China
- Department of Nutrition, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Anand Vaidya
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital & Harvard Medical School, Boston, Massachusetts
| | - Shoulin Wu
- Department of Internal Medicine, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| |
Collapse
|
5
|
Abstract
Incretin-based therapy has clearly emerged as one of the most sought out strategy in managing type 2 diabetes, primarily because they generally do not causes hypoglycemia and possess weight-neutral or weight losing properties. Efficacy-wise too, these agents, are more or less similar to commonly used drugs metformin and sulfonylureas. Interestingly, some studies recently suggested that glycemic response to these incretin-based therapies could also differ ethnicity-wise. Subsequently, meta-analysis from these studies also suggested that Asians may have better response to these incretin-based therapies. This review will be an attempt to critically analyze those studies available in literature and to address as to why East-Asians and South-Asians may have different incretin response compared to non-Asians.
Collapse
Affiliation(s)
- Awadhesh Kumar Singh
- Consultant Endocrinologist, G.D. Diabetes Hospital, Kolkata, West Bengal, and Sun Valley Diabetes Hospital, Guwahati, Assam, India
| |
Collapse
|
6
|
Ma RCW, Chan JCN. Type 2 diabetes in East Asians: similarities and differences with populations in Europe and the United States. Ann N Y Acad Sci 2013; 1281:64-91. [PMID: 23551121 PMCID: PMC3708105 DOI: 10.1111/nyas.12098] [Citation(s) in RCA: 552] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is an epidemic of diabetes in Asia. Type 2 diabetes develops in East Asian patients at a lower mean body mass index (BMI) compared with those of European descent. At any given BMI, East Asians have a greater amount of body fat and a tendency to visceral adiposity. In Asian patients, diabetes develops at a younger age and is characterized by early β cell dysfunction in the setting of insulin resistance, with many requiring early insulin treatment. The increasing proportion of young-onset and childhood type 2 diabetes is posing a particular threat, with these patients being at increased risk of developing diabetic complications. East Asian patients with type 2 diabetes have a higher risk of developing renal complications than Europeans and, with regard to cardiovascular complications, a predisposition for developing strokes. In addition to cardiovascular-renal disease, cancer is emerging as the other main cause of mortality. While more research is needed to explain these interethnic differences, urgent and concerted actions are needed to raise awareness, facilitate early diagnosis, and encourage preventive strategies to combat these growing disease burdens.
Collapse
Affiliation(s)
- Ronald C W Ma
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong, China.
| | | |
Collapse
|
7
|
Influence of telmisartan on insulin response after glucose loading in obese patients with hypertension: ARB trial of hypertension in obese patients with hyperinsulinemia assessed by oral glucose tolerance test (ATHLETE). Adv Ther 2011; 28:698-706. [PMID: 21744143 DOI: 10.1007/s12325-011-0040-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The number of patients with both hypertension and obesity has been increasing in Japan. Many of these patients may also have insulin resistance. Telmisartan, an angiotensin II receptor blocker (ARB), selectively activates peroxisome proliferatoractivated receptor (PPAR)-gamma, and this effect is considered to markedly improve insulin resistance in obese patients with hypertension. We compared the antihypertensive and insulin resistance-improving effects of telmisartan with those of candesartan and valsartan in this patient population. METHODS Twenty-eight elderly patients with an average body mass index (BMI) of 27.1 kg/m(2) were enrolled in this 6-month study. Patients were randomly selected to either switch from candesartan or valsartan to telmisartan or to continue with their current ARB. A 75 g oral glucose tolerance test (OGTT) was performed before and after switching, and the effect of telmisartan on the insulin response to glucose loading was investigated. RESULTS There was no significant difference in blood pressure between the two groups after drug administration, but glucose tolerance significantly improved in the telmisartan group. The hyperinsulin response to glucose loading also significantly improved in those taking telmisartan, as well as homeostasis model assessment of insulin resistance (HOMA-IR). These changes were not observed in the control group. CONCLUSION In patients with hypertension and obesity showing insulin resistance, treatment with telmisartan significantly improved the hyperinsulin response to glucose loading. Telmisartan may therefore be beneficial in these patients.
Collapse
|
8
|
Takeuchi M, Okamoto K, Takagi T, Ishii H. Ethnic difference in patients with type 2 diabetes mellitus in inter-East Asian populations: a systematic review and meta-analysis focusing on gene polymorphism. J Diabetes 2009; 1:255-62. [PMID: 20923526 DOI: 10.1111/j.1753-0407.2009.00040.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND We previously reported that the fasting serum insulin level was significantly lower in Japanese patients than in Korean and Chinese patients, and showed evidence that a difference in the dietary component would be one of the most influential factors for the ethnic difference. However, it is well known that type 2 diabetes mellitus (T2DM) results from the interaction between genetic predispositions and environmental risk factors. Therefore, we investigated ethnic differences by focusing on gene polymorphism, possibly related to T2DM in Japanese, Korean, and Chinese subjects. METHODS Data sources included MEDLINE and EMBASE between January 2001 and October 2008. We conducted a search for articles containing minor allele frequency (MAF) in the gene polymorphisms of peroxisome proliferator-activated receptor-γ (PPARG), inward-rectifying potassium channel Kir6.2 (KCNJ11), Calpain 10 (CAPN10), and transcription factor 7-like 2 (TCF7L2). The pooled odds ratio was calculated by using a fixed-effects model with the Mantel-Haenszel method after confirming statistical evidence of homogeneity across the ethnicities using the Breslow-Day test. RESULTS The Breslow-Day test revealed that there were no statistically significant differences between ethnicities in pooled odds ratios for the gene polymorphisms in PPARG (P = 0.828), KCNJ11 (P = 0.194), CAPN10 (P = 0.090), and TCF7L2 (P = 0.376). Also, pooled odds ratios of each gene polymorphism in East Asians were 0.645 for PPARG (P = 0.000), 1.168 for KCNJ11 (P = 0.000), 0.967 for CAPN10 (P = 0.759), and 1.386 for TCF7L2 (P = 0.000). CONCLUSION The results of this study and our previous studies suggest that behavioral and environmental risk factors have a more significant impact on ethnic difference in East Asian patients with T2DM compared with genetic predispositions.
Collapse
Affiliation(s)
- Masakazu Takeuchi
- Pharmaceutical Information Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.
| | | | | | | |
Collapse
|
9
|
Current literature in diabetes. Diabetes Metab Res Rev 2009; 25:i-viii. [PMID: 19267326 DOI: 10.1002/dmrr.952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
10
|
Takeuchi M, Okamoto K, Takagi T, Ishii H. Ethnic difference in inter-East Asian subjects with normal glucose tolerance and impaired glucose regulation: a systematic review and meta-analysis focusing on fasting serum insulin. Diabetes Res Clin Pract 2008; 82:383-90. [PMID: 18945510 DOI: 10.1016/j.diabres.2008.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 07/02/2008] [Accepted: 09/01/2008] [Indexed: 11/25/2022]
Abstract
AIMS To investigate ethnic difference by focusing on fasting serum insulin (FSI) in inter-East Asian subjects with normal glucose tolerance (NGT) and impaired glucose regulation (IGR). METHODS Data sources included MEDLINE and EMBASE between 2001 and 2007. We conducted a search for articles containing mean or geometric mean values of FSI in East Asian subjects with NGT, IGR, or type 2 diabetes (T2DM). The Monte Carlo method was used for simulation of the mean and standard deviation of individual measures in each ethnic group; calculation of the median ratio and 95% confidence interval of individual measures between ethnic groups. RESULTS Twenty-two articles fully met our pre-determined criteria and were included in the meta-analysis. Results of the meta-analysis revealed that FSI level is significantly lower in Japanese subjects with NGT, IGR, or T2DM than in Korean and Chinese subjects. CONCLUSIONS Ethnic difference in FSI level between East Asians was observed in not only T2DM patients but also subjects with NGT or IGR. The lower FSI level in Japanese subjects was accompanied by lower triglyceride level. These results suggest that ethnic difference in dietary habit was one of the most influential factors for the ethnic difference in FSI.
Collapse
Affiliation(s)
- Masakazu Takeuchi
- Pharmaceutical Information Science, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, Japan.
| | | | | | | |
Collapse
|