Risk factors for developing prediabetes

Non-linear relationship between pulse pressure and the risk of prediabetes: a 5-year cohort study in Chinese adults

Previous research has established a strong link between pulse pressure (PP) and diabetes, but there is limited investigation into the connection between PP and prediabetes. This study aims to explore the potential association between PP and prediabetes. A retrospective cohort study encompassed 202,320 Chinese adults who underwent health check-ups between 2010 and 2016. Prediabetes was defined in accordance with the World Health Organization criteria, indicating impaired fasting glucose, with fasting blood glucose levels ranging from 6.1 to 6.9 mmol/L. To assess the PP-prediabetes relationship, we employed Cox regression analysis, sensitivity analysis, and subgroup analysis. Cox proportional hazards regression, coupled with cubic spline functions and smooth curve fitting, helped elucidate the non-linear PP-prediabetes relationship. Upon adjusting for confounding factors, we observed a positive association between PP and prediabetes (HR 1.15, 95% CI 1.11-1.18, P < 0.0001). Participants in the fourth quartile (PP ≥ 51 mmHg) had a 73% higher likelihood of developing prediabetes compared to those in the first quartile (PP < 36 mmHg) (HR 1.73, 95% CI 1.52-1.97, P < 0.0001). Moreover, the relationship between PP and prediabetes was non-linear. A two-piece Cox proportional hazards regression model identified an inflection point at 40 mmHg for PP (P for log-likelihood ratio test = 0.047). Sensitivity and subgroup analyses corroborated the robustness of our findings. Our study reveals a non-linear correlation between PP and prediabetes, signifying an increased risk of prediabetes when PP levels exceed 40 mmHg. This discovery has significant clinical implications for early prediabetes prevention and intervention, ultimately contributing to improved patient outcomes and quality of life.

Effect of -55C/T Polymorphism of Uncoupling Protein 3 Gene on Risk for New-Onset Diabetes in Chinese Peritoneal Dialysis Patients: A Prospective Cohort Study

BACKGROUND

A high-glucose load in therapy can cause new-onset diabetes (NOD) in peritoneal dialysis (PD) patients. Genetic variability may result in risk modulation.

OBJECTIVES

This study aims to investigate the association between -55C/T polymorphism of uncoupling protein 3 (UCP3) gene and the risk of NOD in PD patients.

METHODS

Nondiabetic incident PD patients between May 2005 and January 2017 were recruited (n = 154). -55C/T polymorphism of the UCP3 was genotyped in all participants at baseline. The cohort of wild group (-55CC) and mutant group (-55CT or -55TT) was built based on the genotypic difference. Insulin resistance was evaluated by the homeostasis model assessment method (HOMA-IR) during the follow-up. Binary logistic regression was performed to explore the association between HOMA-IR and genotypes. Competitive risk analysis was used to analyze the impact of -55C/T polymorphism of UCP3 on risk for NOD.

RESULTS

The cohort was followed for up to 164.6 months (median: 58.3 months; interquartile range: 30.7 months). During the follow-up, 14 NODs occurred in the mutant group, while only 3 occurred in the wild group. Patients in the mutant group had higher HOMA-IR (Odd ratio: 2.210; 95% CI: 1.043-4.680; p = 0.038). Genotype with the variant T allele turned out to be an independent predictor for NOD morbidity (HR: 7.639; 95% CI: 1.798-32.451; p = 0.006).

CONCLUSIONS

The variant of T allele of UCP3 -55C/T polymorphism was an independent predictor for NOD in PD patients. Early identification of the genotype may provide scientific basis for patients' clinic management.

Baicalin serves a protective role in diabetic nephropathy through preventing high glucose-induced podocyte apoptosis

Diabetic nephropathy (DN) is one of the late complications of diabetes, which seriously affects the lives of patients. Baicalin (BA) is a flavone glycoside that has been identified to improve renal function in patients with DN. The present study aimed to investigate the roles and mechanisms of BA in DN. For that purpose, podocytes were cultured for 48 h under conditions of high glucose (HG; 30 mM D-glucose) or normal glucose (NG; 5 mM D-glucose). Then, the cells were treated with different concentrations of BA (6.25, 12.5 and 25 µM) for 24 h. Cell viability and apoptosis were determined using an MTT assay and flow cytometry, respectively. Protein and mRNA expression levels were analyzed using western blotting and reverse transcription-quantitative PCR, respectively. BA treatment was identified to promote the viability of podocytes and suppress cell apoptosis in a dose-dependent manner. Compared with the results in the NG group, HG stimulation significantly decreased the viability of podocytes and increased the apoptotic rate, whereas BA treatment following HG stimulation increased the viability of podocytes and decreased the apoptotic rate. Moreover, the effect of BA was revealed to be associated with the sirtuin 1/NF-κB signaling pathway in DN. In conclusion, the results of the present study suggested that BA treatment may significantly decrease HG-induced podocyte apoptosis, which indicated that BA might be a promising agent for DN treatment.