Parental history of type 2 diabetes is associated with lower resting energy expenditure in normoglycemic subjects

Plasma Sphingolipid Profile of Healthy Black and White Adults Differs Based on Their Parental History of Type 2 Diabetes

CONTEXT

Ceramides and sphingolipids have been linked to type 2 diabetes (T2D). The Ceramides and Sphingolipids as Predictors of Incident Dysglycemia (CASPID) study is designed to determine the association of plasma sphingolipids with the pathophysiology of human T2D.

OBJECTIVE

A comparison of plasma sphingolipids profiles in Black and White adults with (FH+) and without (FH-) family history of T2D.

DESIGN

We recruited 100 Black and White FH- (54 Black, 46 White) and 140 FH+ (75 Black, 65 White) adults. Fasting plasma levels of 58 sphingolipid species, including 18 each from 3 major classes (ceramides, monohexosylceramides, and sphingomyelins, all with 18:1 sphingoid base) and 4 long-chain sphingoid base-containing species, were measured by liquid chromatography/mass spectrometry.

RESULTS

Sphingomyelin was the most abundant sphingolipid in plasma (89% in FH-), and was significantly elevated in FH+ subjects (93%). Ceramides and monohexosylceramides comprised 5% and 6% of total sphingolipids in the plasma of FH- subjects, and were reduced significantly in FH+ subjects (3% and 4%, respectively). In FH+ subjects, most ceramide and monohexosylceramide species were decreased but sphingomyelin species were increased. The level of C18:1 species of all 3 classes was elevated in FH+ subjects.

CONCLUSION

Elevated levels of sphingomyelin, the major sphingolipids of plasma, and oleic acid-containing sphingolipids in healthy FH+ subjects compared with healthy FH- subjects may reflect heritable elements linking sphingolipids and the development of T2D.

Resting energy expenditure in Korean type 2 diabetes patients: comparison between measured and predicted values

BACKGROUND/OBJECTIVES

Estimation of energy demand using resting energy expenditure (REE) is a reasonable approach for optimizing glycemic control and weight management in patients with type 2 diabetes mellitus (T2DM). This study aimed to compare REE predictions and objective measurements in patients with T2DM in Korea.

SUBJECTS/METHODS

This study enrolled 36 participants with T2DM (age range, 20-60 years). Anthropometric variables including height, weight, waist-hip ratio, blood pressure, body fat, body fat percentage, and total body weight were measured using bioimpedance. REE was evaluated using indirect calorimetry. The measured REE values were compared to values estimated using five predictive equations: the Harris-Benedict, Mifflin, Owen, Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO), and Schofield equations. This study evaluated the associations between measured REE values and anthropometric/clinical data, including height, weight, and age, using multivariate linear regression.

RESULTS

The mean measured REE value was 1891.79 ± 288.03 kcal/day (male), 1,502.00 ± 202.96 kcal/day (female). REE estimates generated from the Mifflin equation showed the largest differences from measured REE values, whereas estimates derived from the FAO/WHO equation were the closest to the measured REE values. This study also identified associations between measured REE values and various anthropometric/clinical variables.

CONCLUSION

The accuracy of REE prediction equations is critically important in promoting the efficacy of dietary counseling and the effective treatment of diabetes. Our results indicate the need for additional studies informing more suitable methods for determining the energy requirements of Korean patients with T2DM.

Time to Development of Overt Diabetes and Macrovascular and Microvascular Complications Among Patients With Prediabetes: A Retrospective Cohort Study

Objective In this study, we aimed to determine the effect of age, gender, race, and obesity on the development of overt diabetes and macro/microvascular events among patients with prediabetes. Methods This was a retrospective cohort study of patient records available through a national electronic health record (EHR) database from 2012 to 2017. Patients with prediabetes in the baseline year of 2012 were identified. Macro/microvascular events were defined as the diagnosis of myocardial infarction (MI), stroke, or chronic kidney disease (CKD). The effects of age, gender, race, and obesity on the incidence of diabetes and macro/microvascular events between 2013-2017 were assessed using the multivariate Cox proportional-hazards model. Results Among the total 5,230 patients with prediabetes in 2012, 16.7% developed overt diabetes, and 19.7% developed a macro/microvascular event. Elderly patients (HR: 2.96, 95% CI: 2.12-4.13), males (HR: 1.38, 95% CI: 1.20-1.59), and African-Americans (HR: 1.47, 95% CI: 1.26-1.73) were at a higher risk of experiencing a macro/microvascular event. Additionally, male gender (HR: 1.27, 95% CI: 1.11-1.46) and obesity (HR: 1.24, 95% CI: 1.08-1.43) were significant factors associated with the development of overt diabetes. Furthermore, when diabetes status was added as an interaction term to the Cox proportional-hazards model, no statistical difference was found with respect to any of the other independent variables. It can therefore be inferred that those with prediabetes and overt diabetes had a similar risk of developing macro/microvascular events. Conclusions Based on our findings, factors including advanced age, obesity, male gender, and African race significantly impact the progression to diabetes and associated macro/microvascular events.

Exercise-Induced Improvements in Insulin Sensitivity Are Not Attenuated by a Family History of Type 2 Diabetes

Introduction: A family history of type 2 diabetes (FH+) is a major risk factor for the development of insulin resistance and type 2 diabetes. However, it remains unknown whether exercise-induced improvements in insulin sensitivity and metabolic flexibility are impacted by a FH+. Therefore, we investigated whether improvements in insulin sensitivity, metabolic flexibility, body composition, aerobic fitness and muscle strength are limited by a FH+ following eight weeks of combined exercise training compared to individuals without a family history of type 2 diabetes (FH-). Methods: Twenty (n = 10 FH-, n = 10 FH+) young, healthy, sedentary, normoglycemic, Mexican-American males (age: FH- 22.50 ± 0.81, FH+ 23.41 ± 0.86 years; BMI: FH- 27.91 ± 1.55, FH+ 26.64 ± 1.02 kg/m²) underwent eight weeks of combined aerobic and resistance exercise training three times/week (35 min aerobic followed by six full-body resistance exercises). Insulin sensitivity was assessed via hyperinsulinemic euglycemic clamps. Metabolic flexibility was assessed by the change in respiratory quotient from fasted to insulin-stimulated states. Body composition was determined using dual-energy x-ray absorptiometry. Aerobic fitness was determined by a graded exercise test, and upper- and lower-body strength were assessed via one-repetition maximum bench press and leg strength dynamometer, respectively. Results: Insulin sensitivity, metabolic flexibility, aerobic fitness and strength were not different between groups (p > 0.05). Eight weeks of combined aerobic and resistance exercise training improved insulin sensitivity (FH- p = 0.02, FH+ p = 0.002), increased fat free mass (FH- p = 0.006, FH+ p = 0.001), aerobic fitness (FH- p = 0.03, FH+ p = 0.002), and upper- (FH- p = 0.0001, FH+ p = 0.0001) and lower-body strength (FH- p = 0.0009, FH+ p = 0.0003), but did not change metabolic flexibility (p > 0.05) in both groups. Exercise-induced improvements in metabolic outcomes were similar between groups. Conclusions: Insulin sensitivity, metabolic flexibility, aerobic fitness and strength were not compromised by a FH+. Additionally, a FH+ is not a limiting factor for exercise-induced improvements in insulin sensitivity, aerobic fitness, body composition, and strength in normoglycemic young Mexican-American men.

Association between MIC-1 and Type 2 Diabetes: A Combined Analysis

BACKGROUND AND OBJECTIVES

Type 2 diabetes mellitus (T2DM) is an epidemic disease that endangers human health seriously. Recently, a large number of reports have revealed that macrophage-inhibiting cytokine-1 (MIC-1) is linked with T2DM, but the results were inconclusive. The aim of this study was to perform bioinformatics analysis of the association between MIC-1 and T2DM.

MATERIAL AND METHODS

Datasets and relevant literatures were searched in Gene Expression Omnibus (GEO), PubMed, Google Scholar, and Web of Science till September 20, 2019. Expression levels of MIC-1 were extracted, pooled, and compared between T2DM cases and controls.

RESULTS

In summary, 11 GEO datasets and 3 articles with 421 T2DM cases and 711 controls were finally included. The expression level of MIC-1 was significantly higher in T2DM patients compared with controls, with a standard mean difference (SMD) of 0.54 and a 95% confidence interval (95% CI) of 0.24-0.83; in blood samples, the difference was still significant (SMD = 0.65; 95%CI = 0.24-1.06). Meanwhile, the expression level of MIC-1 plays a significant role in differentiating T2DM cases from controls; the combined sensitivity, specificity, and odds ratio were 0.83 (95%CI = 0.72-0.90), 0.59 (95%CI = 0.45-0.72), and 1.64 (95%CI = 1.35-1.99), respectively. The summary receiver operating characteristic (SROC) curve demonstrated that the area under the curve (AUC) was 0.81 (95%CI = 0.77-0.84).

CONCLUSION

Our results suggested that the expression levels of MIC-1 were significantly higher in T2DM patients in multiple tissues including blood samples.

Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity

PURPOSE OF REVIEW

Excessive adiposity has become a public health problem worldwide, contributing to the rise in obesity-related diseases and associated morbidity and mortality. This review details the relative significance of race/ethnicity as it pertains to adiposity and non-alcoholic fatty liver disease (NAFLD).

RECENT FINDINGS

Fat distribution remains a more reliable measure of adiposity than anthropometric measures, with visceral adipose tissue (VAT) associated with increased risk of cardiometabolic disease. While obesity is the most common risk factor for NAFLD, the racial/ethnic prevalence of obesity does not completely parallel NAFLD risk. Combating racial/ethnic disparities in obesity requires understanding differential risk among various groups. Hispanics are disproportionally impacted by NAFLD and have high rates of obesity, VAT, and insulin resistance (IR). This contrasts with Blacks, who have high prevalence of obesity and IR, accompanied by a paradoxically favorable lipid profile and low prevalence of VAT and NAFLD. Many features of adiposity and NAFLD are mediated by genetic and environmental factors, the latter being modifiable and the focus of interventions.

Total energy expenditure is comparable between patients with and without diabetes mellitus: Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) Study

OBJECTIVE

Assessment of total energy expenditure (TEE) is essential for appropriate recommendations regarding dietary intake and physical activity in patients with and without diabetes mellitus (DM). However, few reports have focused on TEE in patients with DM, particularly in Asian countries. Therefore, we evaluated TEE in Japanese patients with DM using the doubly labeled water (DLW) method and physical activity level (PAL).

RESEARCH DESIGN AND METHODS

In this cross-sectional observational study, we evaluated 52 patients with type 2 DM and 15 patients without DM. Free-living TEE was measured over 12-16 days by the DLW method, and PAL was calculated as TEE divided by the basal metabolic rate (BMR) as assessed by indirect calorimetry. The equivalence margin was defined as 5 kcal/kg/day.

RESULTS

The numbers of patients with DM treated with insulin, oral antidiabetic drugs, and diet were 18 (34.6%), 20 (38.5%), and 14 (26.9%), respectively. The mean±SD level of glycated hemoglobin was 6.9%±0.8% and 5.5%±0.3% in the DM and non-DM group, respectively (p<0.001). The mean body mass index was 23.3±3.0 and 22.7±2.1 kg/m² in the DM and non-DM group, respectively. The mean TEE per kilogram body weight adjusted for sex and age was 36.5 kcal/kg/day and 37.5 kcal/kg/day in the DM and non-DM group, respectively, with no significant difference (mean difference, -1.0 kcal/kg/day; 95% CI -4.2 to 2.3 kcal/kg/day). The BMR tended to be higher in the DM than in the non-DM group (mean difference, 33 kcal/day; 95% CI, -15 to 80 kcal/day). The mean PAL adjusted for sex and age was 1.71 and 1.81 in the DM and non-DM group, respectively, without a significant difference (mean difference, -0.10; 95% CI -0.21 to 0.01).

CONCLUSION

TEE was comparable between Japanese patients with and without DM.

TRIAL REGISTRATION NUMBER

UMIN000023051.