Association Between Prediabetes and Retinopathy: A Meta-Analysis

Observation on clinical effect of Huoxue-Jiangtang decoction formula granules in treating prediabetes: a randomized prospective placebo-controlled double-blind trial protocol

Background

Prediabetes is a hypermetabolic syndrome with blood sugar levels falling between the normal and diabetes. People with prediabetes have a significantly increased chances of developing diabetes, cardiovascular and cerebrovascular diseases, tumors, dementia, and other diseases in the future when compared to the healthy population. However, prediabetes is mainly treated based on lifestyle intervention, currently without targeted drug treatment plan. Traditional Chinese medicine (TCM), which has a longstanding experience, has been shown in clinical studies to be effective for the treatment of diabetes and its related complications. Furthermore, different dosage forms such as decoction and granule have developed gradually in clinical application. Preliminary studies have found that Huoxue-Jangtang Decoction (HJD), with good hypoglycemic and lipid-regulating effects, is potentially one of the complementary and alternative treatments for prediabetes. Therefore, this project intends to perform a prospective clinical study to observe the clinical effectiveness of HJD on prediabetes and the consistency of the efficacy of formula granules and the elixation.

Methods

This is a prospective, randomized, double-blind, and placebo-controlled clinical trial. A total of 183 participants are randomly assigned to HJD Formula Granules plus lifestyle intervention, HJD Elixation plus lifestyle intervention, and placebo plus lifestyle intervention. All subjects undergo 1 day of screening before participating in the study, followed by 84 days of drug intervention and observation. During and after treatment, the main outcome measures include fasting blood glucose and 2-hour postprandial blood glucose.

Discussion

This research attempts to verify the clinical efficacy and possible mechanism of HJD in the treatment of prediabetes, and prove the consistency of HJD Formula Granules with HJD Elixation. This study also aims to provide a treatment that is both effective and safe for prediabetic patients.

Trial registration

ClinicalTrials.gov Identifier: ChiCTR2200060813, Registered 12 June 2022.

Prenatal Alcohol Exposure and the Risk of Depression in Offspring: a Meta-Analysis

BACKGROUND

Prenatal alcohol exposure (PAE) has been related to poor consequences of mental health in offspring. However, it remains unknown whether maternal alcohol drinking during pregnancy is associated with depression in the offspring.

METHODS

A meta-analysis was performed accordingly. Relevant observational studies were identified from Medline, Embase, and Web of Science databases. A fixed-effect or a random-effect model was selected dependending on the between-study heterogeneity.

RESULTS

Eight cohort studies were included. The heterogeneity was not significant (I ² = 14%). A meta-analysis with a fixed-effect model showed that PAE was associated with a higher risk of depression in offspring (odds ratio (OR): 2.28, 95% confidence interval (CI): 1.61 to 3.25, p < 0.001). Subgroup analysis showed that moderate (OR: 1.74, 95% CI: 1.22 to 2.49, p=0.002, I ² = 0%) or heavy (OR: 2.41, 95% CI: 1.55 to 3.73, p < 0.001, I ² = 0%) maternal alcohol drinking in pregnancy was associated with depression in offspring, but not for those with low maternal alcohol drinking (OR: 1.18, 95% CI: 0.97 to 1.44, p=0.10, I ² = 0%). Further subgroup analyses according to study design, timing of PAE evaluation, age at depression diagnosis, and quality scores showed consistent results. Univariate metaregression showed a dose-response association between PAE and offspring depression (coefficient: 0.073, 95% CI: 0.019 to 0.127, p=0.014).

CONCLUSIONS

Current evidence suggests that PAE may be a risk factor of depression in offspring.

Comparison of Bone Mineral Density in US Adults With Diabetes, Prediabetes and Normoglycemia From 2005 to 2018

BACKGROUND

Accumulating evidence has shown that diabetes has an impact on bone metabolism with conflicting results. Furthermore, little is known about the relationship of prediabetes with bone mineral density (BMD). Therefore, we explored the association between BMD and glucometabolic status in adults in the US.

METHODS

In this cross-sectional study, we extracted and analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. A total of 14610 subjects aged 40 ≥ years diagnosed with diabetes, prediabetes, or normal glucose regulation (NGR) and had available data on BMD were eligible.

RESULTS

The prevalence of prediabetes and diabetes in US adults aged 40 ≥ years were 39.2% and 26.4%, respectively. After multivariable adjustment, we found an increasing trend of BMD at the total hip, femoral neck, and lumbar spine with glucometabolic conditions from NGR and prediabetes to diabetes in adults aged ≥ 40 years in the US. This trend was more prominent in women than that in men. Fasting plasma glucose (FPG) and HbA1c levels were also positively correlated with BMD.

CONCLUSIONS

Glucometabolic conditions were significantly associated with BMD values in US adults.