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Bantle AE, Lau KJ, Wang Q, Malaeb S, Harindhanavudhi T, Manoogian ENC, Panda S, Mashek DG, Chow LS. Time-restricted eating did not alter insulin sensitivity or β-cell function in adults with obesity: A randomized pilot study. Obesity (Silver Spring) 2023; 31 Suppl 1:108-115. [PMID: 36518093 PMCID: PMC9877119 DOI: 10.1002/oby.23620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Decreased insulin sensitivity and impairment of β-cell function predate and predict development of type 2 diabetes mellitus. Time-restricted eating (TRE) might have a benefit for these parameters. The objective of this pilot study was to investigate this possibility. METHODS Secondary analysis of a randomized controlled trial comparing 12 weeks of TRE (8-hour eating window) to unrestricted eating (non-TRE) was performed. Participants were adults with overweight or obesity and without diabetes. Two-hour oral glucose tolerance testing was performed at baseline and end-intervention. Glucose tolerance test-derived measures of insulin sensitivity, insulin secretion, and β-cell function were compared between groups. RESULTS Participants (17 women/3 men with mean [SD] age 45.5 [12.1] years and BMI 34.1 [7.5] kg/m2 ) with a prolonged eating window (15.4 [0.9] hours) were randomized to TRE (n = 11) or non-TRE (n = 9). The quantitative insulin sensitivity check index (QUICKI), Stumvoll index, Avignon index, insulinogenic index, insulin area under the curve/glucose area under the curve, and oral disposition index did not differ between the TRE and non-TRE groups at end-intervention. CONCLUSIONS In adults with overweight or obesity and without diabetes, TRE did not significantly alter insulin sensitivity, insulin secretion, or β-cell function over a 12-week intervention. Whether TRE is beneficial in adults with prediabetes or type 2 diabetes mellitus warrants further investigation.
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Affiliation(s)
- Anne E. Bantle
- Division of Diabetes, Endocrinology and Metabolism, Department of MedicineUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kheng Joe Lau
- EndocrinologyWestern Wisconsin HealthBaldwinWisconsinUSA
| | - Qi Wang
- Clinical and Translational Science InstituteUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Samar Malaeb
- Department of EndocrinologyPark Nicollet Health ServicesSaint Louis ParkMinnesotaUSA
| | - Tasma Harindhanavudhi
- Division of Diabetes, Endocrinology and Metabolism, Department of MedicineUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Emily N. C. Manoogian
- Regulatory Biology LaboratorySalk Institute for Biological StudiesLa JollaCaliforniaUSA
| | - Satchidananda Panda
- Regulatory Biology LaboratorySalk Institute for Biological StudiesLa JollaCaliforniaUSA
| | - Douglas G. Mashek
- Department of Biochemistry, Molecular Biology, and BiophysicsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Lisa S. Chow
- Division of Diabetes, Endocrinology and Metabolism, Department of MedicineUniversity of MinnesotaMinneapolisMinnesotaUSA
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2
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Utzschneider KM, Younes N, Rasouli N, Barzilay J, Banerji MA, Cohen RM, Gonzalez EV, Mather KJ, Ismail-Beigi F, Raskin P, Wexler DJ, Lachin JM, Kahn SE. Association of glycemia with insulin sensitivity and β-cell function in adults with early type 2 diabetes on metformin alone. J Diabetes Complications 2021; 35:107912. [PMID: 33752962 PMCID: PMC8048071 DOI: 10.1016/j.jdiacomp.2021.107912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/17/2021] [Accepted: 03/06/2021] [Indexed: 12/31/2022]
Abstract
AIMS Evaluate the relationship between measures of glycemia with β-cell function and insulin sensitivity in adults with early type 2 diabetes mellitus (T2DM). METHODS This cross-sectional analysis evaluated baseline data from 3108 adults with T2DM <10 years treated with metformin alone enrolled in the Glycemia Reduction Approaches in Diabetes. A Comparative Effectiveness (GRADE) Study. Insulin and C-peptide responses and insulin sensitivity were calculated from 2-h oral glucose tolerance tests. Regression models evaluated the relationships between glycemic measures (HbA1c, fasting and 2-h glucose), measures of β-cell function and insulin sensitivity. RESULTS Insulin and C-peptide responses were inversely associated with insulin sensitivity. Glycemic measures were inversely associated with insulin and C-peptide responses adjusted for insulin sensitivity. HbA1c demonstrated modest associations with β-cell function (range: r - 0.22 to -0.35). Fasting and 2-h glucose were associated with early insulin and C-peptide responses (range: r - 0.37 to -0.40) as well as late insulin and total insulin and C-peptide responses (range: r - 0.50 to -0.60). CONCLUSION Glycemia is strongly associated with β-cell dysfunction in adults with early T2DM treated with metformin alone. Efforts to improve glycemia should focus on interventions aimed at improving β-cell function. This Trial is registered in Clinicaltrials.gov as NCT01794143.
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Affiliation(s)
| | - Naji Younes
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | | | | | - Mary Ann Banerji
- State University of New York (SUNY), Downstate Medical Center; Brooklyn, NY
| | - Robert M Cohen
- University of Cincinnati and Cincinnati VA Medical Center; Cincinnati, OH
| | | | | | | | - Philip Raskin
- University of Texas – Southwestern Medical Center; Dallas, Texas
| | - Deborah J Wexler
- Diabetes Research Center, Massachusetts General Hospital, Harvard Medical School; Boston, MA
| | - John M Lachin
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Steven E Kahn
- VA Puget Sound Health Care System and University of Washington; Seattle, WA
| | - GRADE Research Group
- A Listing of GRADE Research Group Members is available on the GRADE Study Webpage: https://grade.bsc.gwu.edu/ancillary-study-info
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3
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Temporal Effects of Sleeve Gastrectomy on Glucose-Insulin Homeostasis and Incretin Hormone Response at 1 and 6 Months. Obes Surg 2021; 30:2243-2250. [PMID: 32067166 PMCID: PMC7475060 DOI: 10.1007/s11695-020-04457-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Bariatric surgery is an effective treatment for morbid obesity and glycaemic dysfunction. OBJECTIVES The aim of the work was to examine both the static and dynamic changes of glucose-insulin homeostasis and incretin hormone response following sleeve gastrectomy (SG) in a sample of 55 participants preoperatively and 1 month and 6 months postoperatively. The focus was on a sample of patients with impaired glucose tolerance and type 2 diabetes (T2D). SETTING Morriston Hospital, UK. METHODS Prospective study comprising of 55 participants with impaired glucose homeostasis and T2D undergoing SG (mean body mass index [BMI] 50.4 kg/m2, mean glycated haemoglobin [A1C] 7.4%). Serial measurements of glucose, insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic hormone (GIP) were performed during oral glucose tolerance testing preoperatively and 1 and 6 months postoperatively. Areas under the curve (AUC) were examined at 30, 60, and 120 min. RESULTS We observed significant improvements in measures of obesity, as well as static and dynamic measures of glucose, insulin, C-peptide and HOMA. Furthermore, significant increases in GLP-1 response as early as 6 months postoperatively were also seen. CONCLUSIONS To our knowledge, no study has examined the detailed dynamic changes in glucose and insulin homeostasis in this number of participants undergoing SG in relation to incretin hormones GIP and GLP-1. This current study supports the role of SG for the treatment of obesity-related glucose dysregulation.
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4
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Martínez-Sánchez FD, Vargas-Abonce VP, Guerrero-Castillo AP, Santos-Villavicencio MDL, Eseiza-Acevedo J, Meza-Arana CE, Gulias-Herrero A, Gómez-Sámano MÁ. Serum Uric Acid concentration is associated with insulin resistance and impaired insulin secretion in adults at risk for Type 2 Diabetes. Prim Care Diabetes 2021; 15:293-299. [PMID: 33218916 DOI: 10.1016/j.pcd.2020.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/21/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023]
Abstract
AIMS Insulin resistance (IR) predisposes to type 2 diabetes mellitus (T2DM). Although previous studies have associated serum uric acid concentration with IR in T2DM, its association with impaired insulin secretion and beta-cell dysfunction in subjects at risk for developing T2DM remains uncertain. Thus, we aimed to analyze the association of serum uric acid concentration with IR using surrogate insulin resistance/secretion and beta-cell function indices in subjects at risk for developing T2DM. METHODS This is a cross-sectional study that included 354 subjects who underwent an oral glucose tolerance test who had at least two risk factors for T2DM without any chronic disease. RESULTS Participants were 51±8 years old, 72.2% were women, had a mean body mass index of 29.9±6.5kg/m2 and mean serum uric acid concentration of 5.7±1.3mg/dL. HOMA-IR, first-phase insulin secretion (S1PhOGTT), second-phase insulin secretion (S2PhOGTT), Matsuda and disposition indices were significantly correlated with serum uric acid concentrations (r=0.239, r=0.225, r=0.201, r=-0.287, r=-0.208; respectively). After multiple linear regression analysis, serum uric acid concentration was independently associated with HOMA-IR (β=0.283), HOMA-B (β=0.185), S1PhOGTT (β=0.203), S2PhOGTT (β=0.186), and Matsuda Index (β=-0.322). A serum uric acid concentration of 5.5mg/dL had the best sensitivity/sensibility to identify subjects with IR (HOMA-IR ≥2.5). CONCLUSIONS Serum uric acid concentration is significantly associated with IR and impaired insulin secretion, but not with beta-cell dysfunction, in subjects at risk for developing T2DM.
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Affiliation(s)
- Froylan D Martínez-Sánchez
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico; Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anáhuac #46. Lomas Anáhuac, 52786 Huixquilucan, Estado de Mexico, Mexico.
| | - Valerie Paola Vargas-Abonce
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | - Anna Paula Guerrero-Castillo
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | | | - Jocelyn Eseiza-Acevedo
- Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, 239, Mexico City, Mexico City, Mexico.
| | - Clara Elena Meza-Arana
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | - Alfonso Gulias-Herrero
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | - Miguel Ángel Gómez-Sámano
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
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Bozkurt L, Göbl CS, Leitner K, Pacini G, Kautzky-Willer A. HbA1c during early pregnancy reflects beta-cell dysfunction in women developing GDM. BMJ Open Diabetes Res Care 2020; 8:e001751. [PMID: 33132213 PMCID: PMC7607595 DOI: 10.1136/bmjdrc-2020-001751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/23/2020] [Accepted: 10/01/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION It is of current interest to assess eligibility of hemoglobin A1c (HbA1c) as a screening tool for earlier identification of women with risk for more severe hyperglycemia in pregnancy but data regarding accuracy are controversial. We aimed to evaluate if HbA1c mirrors pathophysiological precursors of glucose intolerance in early pregnancy that characterize women who develop gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS 220 pregnant women underwent an HbA1c measurement as well as an oral glucose tolerance test (OGTT) with multiple measurements of glucose, insulin and C-peptide for evaluation of insulin sensitivity and beta-cell function at 16th gestational week (IQR: 14-18). Clinical follow-ups were performed until end of pregnancy. RESULTS Increased maternal HbA1c ≥5.7% (39 mmol/mol) corresponding to pre-diabetes outside of pregnancy was associated with altered glucose dynamics during the OGTT. Pregnancies with early HbA1c ≥5.7% showed higher fasting (90.4±13.2 vs 79.7±7.2 mg/dL, p<0.001), mean (145.6±31.4 vs 116.2±21.4 mg/dL, p<0.001) as well as maximum glucose concentrations and tended to a delay in reaching the maximum glucose level compared with those with normal-range HbA1c (186.5±42.6 vs 147.8±30.1 mg/dL, p<0.001). Women with increased HbA1c showed impaired beta-cell function and differences in disposition index independent of body mass index status. We observed a high specificity for the HbA1c cut-off of 5.7% for GDM manifestation (0.96, 95% CI 0.91 to 0.98) or need of glucose-lowering medication (0.95, 95% CI 0.90 to 0.98) although overall predictive accuracy was moderate to fair. Further, elevated HbA1c was associated with higher risk for delivering large-for-gestational-age infants, also after adjustment for GDM status (OR 4.4, 95% CI 1.2 to 15.0, p=0.018). CONCLUSIONS HbA1c measured before recommended routine screening period reflects early pathophysiological derangements in beta-cell function and glucose disposal that are characteristic of GDM development and may be useful in early risk stratification.
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Affiliation(s)
- Latife Bozkurt
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Christian S Göbl
- Division of Obstetrics and Feto-maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Karoline Leitner
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Giovanni Pacini
- Metabolic Unit, National Research Council Padua Research Area, Padova, Veneto, Italy
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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6
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Saunajoki AE, Auvinen JP, Bloigu AH, Timonen MJ, Keinänen-Kiukaanniemi SM. Evaluating the 1-h post-load glucose level to predict future type 2 diabetes. Diabetes Res Clin Pract 2020; 160:108009. [PMID: 31926844 DOI: 10.1016/j.diabres.2020.108009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/06/2019] [Accepted: 01/07/2020] [Indexed: 12/25/2022]
Abstract
AIMS To evaluate the predictive ability of 2-h post-load glucose level in addition to fasting and 1-h glucose levels in predicting the risk of type 2 diabetes. METHODS We examined a prospective population-based cohort study of 654 subjects without type 2 diabetes at baseline. All subjects underwent an oral glucose tolerance test (OGTT), with measurement of glucose at 0, 60, and 120 min at baseline, and after 12 years in a follow-up survey. We evaluated the predictive properties of fasting, 1- and 2-h post-load glucose levels by comparing the areas under the receiver-operating characteristic (ROC) curve. RESULTS We found that 2-h glucose concentration in the prediction model with fasting and 1-h glucose levels did not significantly increase the predictability of type 2 diabetes compared to a model only including fasting and 1-h glucose levels (AUC 0.83 vs. AUC 0.82, respectively; p = 0.23). The area under the ROC curve was the largest for 1-h glucose level (AUC 0.81), compared to fasting (AUC 0.71; p < 0.01) and 2-h glucose levels (AUC 0.72; p = 0.01). CONCLUSIONS Adding 2-h glucose to the model with fasting and 1-h glucose levels did not improve the predictability of new onset type 2 diabetes.
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Affiliation(s)
- Anni E Saunajoki
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Juha P Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Healthcare and Social Services of Oulunkaari, Ii, Finland.
| | - Aini H Bloigu
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Markku J Timonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Healthcare and Social Services of Oulunkaari, Ii, Finland.
| | - Sirkka M Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Healthcare and Social Services of Selänne, Pyhäjärvi, Finland.
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Jang HB, Go MJ, Park SI, Lee HJ, Cho SB. Chronic heavy alcohol consumption influences the association between genetic variants of GCK or INSR and the development of diabetes in men: A 12-year follow-up study. Sci Rep 2019; 9:20029. [PMID: 31882596 PMCID: PMC6934767 DOI: 10.1038/s41598-019-56011-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Chronic heavy alcohol consumption is a risk factor for diabetes, which is characterized by impaired β-cell function and insulin resistance. We aimed to determine whether the longitudinal associations between genetic variants of glucokinase (GCK) and insulin receptor (INSR) and the risk of developing diabetes were influenced by chronic heavy alcohol consumption. Data were obtained from the Korean Genome and Epidemiology Study. To identify candidate variants, 1,520 subjects (726 non-drinkers and 794 heavy drinkers) were included in the baseline cross-sectional study. After excluding patients with diabetes at baseline and those with insufficient data on diabetes incidence, prospective analyses were conducted in 773 subjects (353 non-drinkers and 420 heavy drinkers). In the baseline cross-sectional study, one SNP (rs758989) in GCK and four SNPs (rs7245757, rs1035942, rs1035940, and rs2042901) in INSR were selected as candidate SNPs that interact with alcohol to affect prediabetes and diabetes. We identified that these GCK and INSR polymorphisms are affected by chronic heavy alcohol consumption and have an effect on the incidence of diabetes. The incidence of diabetes was increased in chronic heavy alcohol drinkers carrying the C allele of GCK compared with never-drinkers with the C allele (HR, 2.15; 95% CI 1.30-3.57), and was increased in chronic heavy alcohol drinkers who were not carrying the INSR haplotype (-/-) compared with never-drinkers carrying the AACT haplotype (HR, 1.98; 95% CI 1.24-3.18). Moreover, we observed that the aggravating effects on the late insulin secretion (I/G120 and I/G AUC 60-120) in individuals who were chronic heavy drinkers with C allele of GCK. In the INSR haplotype, chronic heavy drinkers not carrying AACT were associated with lower disposition index. These results potentially suggest that chronic heavy alcohol consumption induce β-cell dysfunction partially mediated by decreased GCK expression or decline of insulin sensitivity via inhibition of INSR, thereby contributing to the development of diabetes.
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Affiliation(s)
- Han Byul Jang
- Center for Biomedical Science, Korea National Institute of Health, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Min Jin Go
- Center for Genome Science, Korea National Institute of Health, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Sang Ick Park
- Center for Biomedical Science, Korea National Institute of Health, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Hye-Ja Lee
- Center for Biomedical Science, Korea National Institute of Health, Cheongju, Chungcheongbuk-do, Republic of Korea.
| | - Seong Beom Cho
- Center for Genome Science, Korea National Institute of Health, Cheongju, Chungcheongbuk-do, Republic of Korea.
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8
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Impaired Insulin Profiles Following a Single Night of Sleep Restriction: The Impact of Acute Sprint Interval Exercise. Int J Sport Nutr Exerc Metab 2019; 30:139–144. [PMID: 31816598 DOI: 10.1123/ijsnem.2019-0235] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/02/2019] [Accepted: 10/18/2019] [Indexed: 11/18/2022]
Abstract
Experimental sleep restriction (SR) has demonstrated reduced insulin sensitivity in healthy individuals. Exercise is well-known to be beneficial for metabolic health. A single bout of exercise has the capacity to increase insulin sensitivity for up to 2 days. Therefore, the current study aimed to determine if sprint interval exercise could attenuate the impairment in insulin sensitivity after one night of SR in healthy males. Nineteen males were recruited for this randomized crossover study which consisted of four conditions-control, SR, control plus exercise, and sleep restriction plus exercise. Time in bed was 8 hr (2300-0700) in the control conditions and 4 hr (0300-0700) in the SR conditions. Conditions were separated by a 1-week entraining period. Participants slept at home, and compliance was assessed using wrist actigraphy. Following the night of experimental sleep, participants either conducted sprint interval exercise or rested for the equivalent duration. An oral glucose tolerance test was then conducted. Blood samples were obtained at regular intervals for measurement of glucose and insulin. Insulin concentrations were higher in SR than control (p = .022). Late-phase insulin area under the curve was significantly lower in sleep restriction plus exercise than SR (862 ± 589 and 1,267 ± 558; p = .004). Glucose area under the curve was not different between conditions (p = .207). These findings suggest that exercise improves the late postprandial response following a single night of SR.
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Aguayo-Mazzucato C, Diaque P, Hernandez S, Rosas S, Kostic A, Caballero AE. Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes Metab Res Rev 2019; 35:e3097. [PMID: 30445663 PMCID: PMC6953173 DOI: 10.1002/dmrr.3097] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022]
Abstract
The prevalence and incidence of type 2 diabetes (T2D) among the Hispanic population in the United States are higher than the national average. This is partly due to sociocultural factors, such as lower income and decreased access to education and health care, as well as a genetic susceptibility to obesity and higher insulin resistance. This review focuses on understanding the Hispanic population living in the United States from a multidisciplinary approach and underlines the importance of cultural, social, and biological factors in determining the increased risk of T2D in this population. An overview of the acute and chronic complications of T2D upon this population is included, which is of paramount importance to understand the toll that diabetes has upon this population, the health system, and society as a whole. Specific interventions directed to the Hispanic populations are needed to prevent and alleviate some of the burdens of T2D. Different prevention strategies based on medications, lifestyle modifications, and educational programmes are discussed herein. Diabetes self-management education (DSME) is a critical element of care of all people with diabetes and is considered necessary to improve patient outcomes. To be more effective, programmes should take into consideration cultural factors that influence the development and progression of diabetes. These interventions aim to enhance long-term effects by reducing the incidence, morbidity, and mortality of T2D in the Hispanic population of the United States.
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Affiliation(s)
| | - Paula Diaque
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sonia Hernandez
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
- Surgery Department, University of Chicago, Chicago, Illinois, USA
| | - Silvia Rosas
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Aleksandar Kostic
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
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10
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Jagannathan R, Buysschaert M, Medina JL, Katz K, Musleh S, Dorcely B, Bergman M. The 1-h post-load plasma glucose as a novel biomarker for diagnosing dysglycemia. Acta Diabetol 2018; 55:519-529. [PMID: 29383586 PMCID: PMC7977481 DOI: 10.1007/s00592-018-1105-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/11/2018] [Indexed: 02/06/2023]
Abstract
Identifying the earliest moment for intervention to avert progression to prediabetes and diabetes in high-risk individuals is a substantial challenge. As β-cell function is already compromised in prediabetes, attention should therefore be focused on identifying high-risk individuals earlier in the so-called pre-prediabetes stage. Biomarkers to monitor progression and identify the time point at which β-cell dysfunction occurs are therefore critically needed. Large-scale population studies have consistently shown that the 1-h plasma glucose (1-h PG) ≥ 155 mg/dl (8.6 mmol/l) during the oral glucose tolerance test detected incident type 2 diabetes and associated complications earlier than fasting plasma glucose or 2-h plasma glucose levels. An elevated 1-h PG level appears to be a better alternative to HbA1c [5.7-6.4% (37-47 mmol/mol)] or traditional glucose criteria for identifying high-risk individuals at a stage when ß-cell function is substantially more intact than in prediabetes. Diagnosing high-risk individuals earlier proffers the opportunity for potentially reducing progression to diabetes, development of microvascular complications and mortality, thereby advancing benefit beyond that which has been demonstrated in global diabetes prevention programs.
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Affiliation(s)
- Ram Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 18, Atlanta, GA, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | | | - Karin Katz
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Sarah Musleh
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Brenda Dorcely
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Michael Bergman
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA.
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Aono D, Oka R, Kometani M, Takeda Y, Karashima S, Yoshimura K, Takeda Y, Yoneda T. Insulin Secretion and Risk for Future Diabetes in Subjects with a Nonpositive Insulinogenic Index. J Diabetes Res 2018; 2018:5107589. [PMID: 29765987 PMCID: PMC5885485 DOI: 10.1155/2018/5107589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/22/2018] [Indexed: 12/14/2022] Open
Abstract
AIM To characterize subjects with a nonpositive insulinogenic index and longitudinally observe changes in their glucose tolerance. SUBJECTS AND METHODS A historical cohort study was conducted using data from the medical checkups of public school workers. Indices of insulin secretion and insulin sensitivity derived from oral glucose tolerance test (OGTT) and the incidences of diabetes and impaired glucose tolerance (IGT) were compared among subgroups of subjects with different insulinogenic index (change in insulin/change in glucose over the first 30 min on the OGTT). RESULTS Of the 1464 nondiabetic subjects at baseline, 72 (4.9%) subjects had a nonpositive insulinogenic index: 42 of those subjects had a nonpositive glucose response (ΔGlu0-30 ≤ 0) and 30 had a nonpositive insulin response (ΔIns0-30 ≤ 0). Compared with subjects who had normal glucose tolerance (NGT) with insulinogenic index ≥ 0.4, subjects with a nonpositive glucose response had a higher first-phase Stumvoll and lower incidences of diabetes and IGT based on a log-rank test (p < 0.05), whereas subjects with a nonpositive insulin response had lower indices of insulin secretion and a higher incidence of diabetes (p < 0.05). CONCLUSIONS These results demonstrate that in the first 30 min on the OGTT, subjects with a nonpositive insulinogenic index due to a nonpositive glucose response (ΔGlu0-30 ≤ 0) had a lower risk for future diabetes and that subjects with nonpositive insulin response (ΔIns0-30 ≤ 0) had a higher risk for future one.
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Affiliation(s)
- Daisuke Aono
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Rie Oka
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
- Department of Internal Medicine, Hokuriku Central Hospital, Oyabe, Japan
| | - Mitsuhiro Kometani
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Yoshimichi Takeda
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Shigehiro Karashima
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Kenichi Yoshimura
- Department of Biostatistics, Innovative Clinical Research Center (iCREK), Kanazawa University Hospital, Kanazawa, Japan
| | - Yoshiyu Takeda
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Takashi Yoneda
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
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12
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Zhang Y, Sun J, Li F, Grogan TR, Vergara JL, Luan Q, Park MS, Chia D, Elashoff D, Joshipura KJ, Wong DTW. Salivary extracellular RNA biomarkers for insulin resistance detection in hispanics. Diabetes Res Clin Pract 2017; 132:85-94. [PMID: 28802700 PMCID: PMC5741087 DOI: 10.1016/j.diabres.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/15/2016] [Accepted: 07/04/2017] [Indexed: 12/25/2022]
Abstract
AIMS Insulin resistance (IR) detection is challenging and no test is currently used in clinical practice. We developed salivary biomarkers that could be used for IR detection. METHODS We collected saliva from 186 healthy and 276 pre-diabetic participants, divided them into high and low IR groups based on a HOMA cutoff of 2.5. We profiled extracellular transcriptome by microarray in saliva supernatant from 23 high IR and 15 low IR participants, and pre-validated the top ten extracellular mRNA (exRNA) markers in a new cohort of 40 high and 40 low IR participants. A prediction panel was then built and validated in an independent cohort of 149 high and 195 low IR participants. RESULTS Transcriptomic analyses identified 42 exRNA candidates differentially present in saliva of high and low IR participants. From the top ten candidates, six were individually validated (PRKCB, S100A12, IL1R2, CAMP, VPS4B, CAP1) (p<0.01) and yielded AUC values ranging from 0.66 to 0.76. Body mass index (BMI) was significant higher in high compared to low IR group with AUC of 0.66, and showed no correlation with any of candidate biomarkers. The combination of four exRNA markers (IL1R2, VPS4B, CAP1, LUZP6) with BMI achieved excellent results in the prediction panel building dataset (AUC=0.79, sensitivity=79%, specificity=64%). The prediction model was validated in an independent cohort (AUC=0.82, sensitivity=63%, specificity=92%). CONCLUSIONS A panel of four salivary exRNA biomarkers (IL1R2, VPS4B, CAP1, LUZP6) and BMI was validated that can distinguish high and low IR participants, overall and in subgroups of healthy and pre-diabetic participants.
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Affiliation(s)
- Yong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China; School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Jie Sun
- School of Medicine, Shenzhen University, Shenzhen, China; School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Feng Li
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Tristan R Grogan
- Department of Biostatistics and Medicine, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jose L Vergara
- Center for Clinical Research and Health Promotion University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico
| | - QingXian Luan
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Moon-Soo Park
- Department of Oral Medicine and Diagnosis, Oral Science Institute, College of Dentistry, Gangneung-Wonju National University, Gangneung, Republic of Korea; School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - David Chia
- Department of Pathology, University of California Los Angeles, Los Angeles, CA, USA
| | - David Elashoff
- Department of Biostatistics and Medicine, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico; Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - David T W Wong
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA.
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13
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Göbl CS, Ott J, Bozkurt L, Feichtinger M, Rehmann V, Cserjan A, Heinisch M, Steinbrecher H, JustKukurova I, Tuskova R, Leutner M, Vytiska-Binstorfer E, Kurz C, Weghofer A, Tura A, Egarter C, Kautzky-Willer A. To Assess the Association between Glucose Metabolism and Ectopic Lipid Content in Different Clinical Classifications of PCOS. PLoS One 2016; 11:e0160571. [PMID: 27505055 PMCID: PMC4978496 DOI: 10.1371/journal.pone.0160571] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/21/2016] [Indexed: 11/18/2022] Open
Abstract
Aims There are emerging data indicating an association between PCOS (polycystic ovary syndrome) and metabolic derangements with potential impact on its clinical presentation. This study aims to evaluate the pathophysiological processes beyond PCOS with particular focus on carbohydrate metabolism, ectopic lipids and their possible interaction. Differences between the two established classifications of the disease should be additionally evaluated. Methods A metabolic characterization was performed in 53 untreated PCOS patients as well as 20 controls including an extended oral glucose tolerance test (OGTT, to assess insulin sensitivity, secretion and ß-cell function) in addition to a detailed examination of ectopic lipid content in muscle and liver by nuclear magnetic resonance spectroscopy. Results Women with PCOS classified by the original NIH 1990 definition showed a more adverse metabolic risk profile compared to women characterized by the additional Rotterdam 2003 phenotypes. Subtle metabolic derangements were observed in both subgroups, including altered shapes of OGTT curves, impaired insulin action and hyperinsulinemia due to increased secretion and attenuated hepatic extraction. No differences were observed for ectopic lipids between the groups. However, particularly hepatocellular lipid content was significantly related to clinical parameters of PCOS like whole body insulin sensitivity, dyslipidemia and free androgen index. Conclusions Subtle alterations in carbohydrate metabolism are present in both PCOS classifications, but more profound in subjects meeting the NIH 1990 criteria. Females with PCOS and controls did not differ in ectopic lipids, however, liver fat was tightly related to hyperandrogenism and an adverse metabolic risk profile.
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Affiliation(s)
- Christian S. Göbl
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Latife Bozkurt
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Feichtinger
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Victoria Rehmann
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Anna Cserjan
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Maike Heinisch
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Helmut Steinbrecher
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Ivica JustKukurova
- High Field Magnetic Resonance Centre of Excellence, Medical University of Vienna, Vienna, Austria
| | - Radka Tuskova
- High Field Magnetic Resonance Centre of Excellence, Medical University of Vienna, Vienna, Austria
| | - Michael Leutner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Vytiska-Binstorfer
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Christine Kurz
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Andrea Weghofer
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Andrea Tura
- Metabolic Unit, Institute of Neuroscience, National Research Council, Padova, Italy
| | - Christian Egarter
- Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria
- * E-mail:
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14
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Lorenzo C, Hanley AJ, Rewers MJ, Haffner SM. Discriminatory value of alanine aminotransferase for diabetes prediction: the Insulin Resistance Atherosclerosis Study. Diabet Med 2016; 33:348-55. [PMID: 26094705 PMCID: PMC5075526 DOI: 10.1111/dme.12835] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 01/17/2023]
Abstract
AIMS To examine the incremental usefulness of adding alanine aminotransferase to established risk factors for predicting future diabetes. METHODS The study population of the Insulin Resistance Atherosclerosis Study included 724 people aged 40-69 years. We excluded people who had excessive alcohol intake or were treated with lipid-lowering agents. Incident diabetes was assessed after a mean follow-up period of 5.2 years. RESULTS Alanine aminotransferase had a non-linear relationship with incident diabetes (Wald chi-squared test, P < 0.001; P for linearity = 0.005) independent of demographic variables, family history of diabetes, BMI and fasting glucose; therefore, we used Youden's J statistic to dichotomize alanine aminotransferase [threshold ≥ 0.43 μkat/L ( ≥ 26 IU/l)]. Dichotomized alanine aminotransferase increased the area under the receiver-operating characteristic curve (0.805 vs. 0.823; P = 0.007) of a model that included demographic variables, family history of diabetes, BMI and fasting glucose as independent variables. The net reclassification improvement was 9.6% (95% CI 1.8-17.4; P = 0.016), and the integrated discrimination improvement was 0.031 (95% CI 0.011-0.050; P = 0.002). Dichotomized alanine aminotransferase reclassified a net of 9.6% of individuals more appropriately. CONCLUSIONS Alanine aminotransferase may be useful for classifying individuals who are at risk of future diabetes after accounting for the effect of other risk factors, including family history, adiposity and plasma glucose.
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Affiliation(s)
- C Lorenzo
- Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - A J Hanley
- Departments of Medicine and Nutritional Sciences and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Leadership Sinai Centre for Diabetes, Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - M J Rewers
- Barbara Davis Center for Childhood Diabetes, University Colorado School of Medicine, Aurora, CO, USA
| | - S M Haffner
- Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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