The characteristics of impaired fasting glucose associated with obesity and dyslipidaemia in a Chinese population

The characteristics and risk of obesity central and concomitant impaired fasting glucose: Findings from a cross-sectional study

INTRODUCTION

Obesity is associated with concomitant chronic conditions. An early metabolic consequence of obesity is disruption of glucose and insulin homeostasis. One of the consequences is impaired fasting glucose (IFG). Visceral fat is metabolically more harmful than subcutaneous fat, but few information is available regarding the association between the risk of abnormal glucose in increased waist circumference.

METHODS

This study is based on a cross sectional of 1,381 population-based from Palembang, Indonesia. The eligibility requirements subject were to be older than 18 and consent to taking fasting glucose and lipid profile tests as well as physical exams measuring their body weight, height, blood pressure, abdominal circumference, and waist circumference.

RESULTS

The number of subjects consisting of 798 noncentral obesity with normoglycemia, 376 central obesity with normoglycemia, and 207 central obesity with concomitant IFG. The prevalence central obesity with concomitant IFG was 35.51%. In subjects with central obesity, there were significant differences in proportions based on sex, age, marital status, education, and occupation. In multivariate analysis show that the risk factors that contribute to having a significant association with central obesity with concomitant IFG are sex (female), age (>40 years), blood pressure (hypertension), and HDL-C <50 mg/dL (p<0.001). The analysis also founded that there was a significant difference in the dietary pattern of sweet foods (p = 0.018), sweet drinks (p = 0.002), soft drinks (p = 0.001) and smoking habit (p<0.001) between subjects with obesity central and concomitant IFG compared to subjects with noncentral obesity. The majority of subjects with obesity central and concomitant IFG had consuming these risky foods >6 times/week.

CONCLUSION

The prevalence of central obesity with IFG is quite high. There are significant differences in the characteristics, lipid profile, blood pressure, dietary pattern, and smoking habit of central obesity with concomitant IFG was confirmed in this population-based observational study.

Glycemia and associated factors in a pediatric population in Mexico

Aims

In this study, we evaluated the association of sociodemographic, lifestyle and cardiometabolic factors with blood glucose levels in children and adolescents in Mexico.

Methods

An analytical cross-sectional study of 642 children and adolescents aged 6 to 19 years from different educational centers located in municipalities of the state of San Luis Potosí, Mexico, was carried out. Pearson χ2 and Spearman correlation tests and multiple linear regression models were used to evaluate the associations of the variables with glycemia.

Results

The prevalence of prediabetes was 8.0% in both sexes. Male participants were more likely to develop hyperglycemia than female participants (OR 2.7, 95% CI: 1.5-5.0). The variables associated with glucose levels were male sex, high socioeconomic status, inadequate diet, high blood pressure, and increased total cholesterol, LDL cholesterol, and triglycerides, which also explained up to 15.6% (p < 0.05) of the variability in glucose concentrations.

Conclusion

The detection of sociodemographic, lifestyle and cardiometabolic factors in children and adolescents will contribute to the implementation of prevention strategies for cardiometabolic diseases, among which prediabetes is common.

Examining dyslipidaemia, metabolic syndrome and liver enzyme levels in patients with prediabetes and type 2 diabetes in population from Hoveyzeh cohort study: A case-control study in Iran

INTRODUCTION

Type 2 diabetes mellitus (T2DM) is among the world's top 10 leading causes of death. Additionally, prediabetes is a major risk factor for diabetes. Identifying diabetes co-occurring disorders can aid in reducing adverse effects and facilitating early detection. In this study, we evaluated dyslipidaemia, metabolic syndrome (MetS), and liver enzyme levels in pre-diabetic and T2DM patients in the Persian cohort compared to a control group.

MATERIALS AND METHODS

In this cross-sectional study, 2259 pre-diabetes, 1664 T2DM and 5840 controls (35-70 years) who were selected from the Hoveyzeh cohort centre were examined. Body mass index, blood pressure, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and liver enzymes: γ-glutamyltransferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using the standard protocols. MetS subjects were also identified based on the National Cholesterol Education Program guidelines.

RESULTS

Prediabetes and T2MD were closely correlated with the lipid profile, MetS, and liver enzymes (ALT, GGT, ALT/AST). MetS increases the risk of T2DM by 12.45 [95% CI: 10.88-14.24] fold, while an increase in ALT/AST ratio increases the risk of T2DM by 3.68 [95% CI: 3.159-4.154] fold. ROC curve analysis also revealed the diagnostic roles of GGT, ALT, AST and the ALT/AST ratio among pre-diabetics, diabetics and the control group. The GGT level corresponds to the highest AUCs (0.685) with the highest sensitivity (70.25%).

CONCLUSIONS

Our results indicated a significant increase in liver enzymes, lipid profile and MetS status in both pre-diabetic and T2MD subjects, with the differences being more pronounced in diabetic individuals. Consequently, on the one hand, these variables may be considered predictive risk factors for diabetes, and on the other hand, they may be used as diagnostic factors. In order to confirm the clinical applications of these variables, additional research is required.

Individual and combined associations of body mass index and waist circumference with components of metabolic syndrome among multiethnic middle-aged and older adults: A cross-sectional study

OBJECTIVES

Body mass index (BMI) and waist circumference (WC) are closely associated with metabolic syndrome and its components. Hence, a combination of these two obesity markers may be more predictive. In this study, we aimed to investigate the individual and combined associations of BMI and WC with selected components of metabolic syndrome and explored whether age, sex and ethnicity affected the aforementioned associations.

METHODS

A total of 6,298 middle-aged and older adults were included. Based on BMI and WC, the participants were divided into 4 groups: comorbid obesity (BMI ≥ 28 kg/m² and WC< 85/90 cm for women/men), abdominal obesity alone (BMI< 28 kg/m² and WC≥ 85/90 cm for women/men), general obesity alone (BMI ≥ 28 kg/m² and WC< 85/90 cm for women/men) and nonobesity subgroups (BMI< 28 kg/m² and WC< 85/90 cm for women/men). Selected components of metabolic syndrome were evaluated using the criteria recommended by the Chinese Diabetes Society. Poisson regression models with robust variance were used to evaluate the associations of obesity groups with selected components of metabolic syndrome. An interaction test was conducted to explore whether age, sex and ethnicity affect the aforementioned associations.

RESULTS

Compared with participants in the reference group (comorbid obesity), participants in the other 3 groups showed a decreased prevalence of fasting hyperglycemia (PR=0.83, 95% CI=0.73-0.94 for abdominal obesity alone, PR=0.60, 95% CI=0.38-0.96 for general obesity alone and PR=0.46, 95% CI=0.40-0.53 for nonobesity), hypertension (PR=0.86, 95% CI=0.82-0.90 for abdominal obesity alone, PR=0.80, 95% CI=0.65-0.97 for general obesity alone and PR=0.69, 95% CI = 0.66-0.73 for nonobesity) and hypertriglyceridemia (PR=0.88, 95% CI=0.82-0.95 for abdominal obesity alone, PR=0.62, 95% CI=0.47-0.81 for general obesity alone and PR=0.53, 95% CI=0.49-0.57 for nonobesity). However, participants in the abdominal obesity alone and nonobesity groups showed a decreased prevalence of low HDL-C levels while participants in the general obesity alone group did not (PR=0.65, 95% CI=0.41-1.03, p>0.05). In addition, the aforementioned associations were not affected by age, sex or ethnicity (all p for interactions>0.05).

CONCLUSIONS

Comorbid obesity is superior to general and abdominal obesity in identifying individuals at high risk of developing metabolic syndrome in middle-aged and older adults. Great importance should be attached to the combined effect of BMI and WC on the prevention and management of metabolic syndrome.

Abnormal fasting blood glucose enhances the risk of long-term exposure to air pollution on dyslipidemia: A cross-sectional study

Both long-term exposure to air pollution and abnormal fasting blood glucose (FBG) are linked to dyslipidemia prevalence. However, the joint role of air pollution and FBG on dyslipidemia remains unknown clearly. In this study, we aimed to test whether abnormal FBG could enhance the risks of long-term exposure to air pollutants on dyslipidemia in general Chinese adult population. The present study recruited 8917 participants from 4 cities in Hebei province, China. Participants' individual exposure to air pollutants was evaluated by the Empirical Bayesian Kriging statistical model in ArcGIS10.2 geographic information system. Dyslipidemia was defined according to Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults. Subjects were grouped into normal, prediabetes, diabetes according to FBG level. Generalized linear models were applied to analyze the interaction of air pollutants and FBG on dyslipidemia prevalence. The prevalence of dyslipidemia was 43.83% in our investigation. After adjusting all covariates, we found the risk of four air pollutants (PM_2.5, PM₁₀, NO₂, SO₂) on dyslipidemia prevalence was stronger as higher FBG level, and the adjusted odd ratio of interaction (OR_inter (95% CI)) between PM_2.5, PM₁₀, NO₂, SO₂ and FBG levels on dyslipidemia was 1.171 (1.162, 1.189), 1.119 (1.111, 1.127), 1.124 (1.115, 1.130), 1.107 (1.098, 1.115), respectively. Stratified analyses indicated the modifying effects of FBG on the association of air pollution with dyslipidemia were stronger among male, less than 65 years old, overweight/obesity (all P_inter<0.1). Our study concluded that high FBG levels strengthened the risk of long-term exposure to air pollution on dyslipidemia, especially more noticeable in male, less than 65 years old, overweight.

A Longitudinal Retrospective Observational Study on Obesity Indicators and the Risk of Impaired Fasting Glucose in Pre- and Postmenopausal Women

The impact of obesity could differ according to menopausal status since women undergo significant physiologic and metabolic changes due to menopause. We investigated the association between various major obesity indicators and the risk of impaired fasting glucose (IFG) according to menopausal status using nationally representative data. A total of 571,286 premenopausal and 519,561 postmenopausal women who underwent both Korean National Health Insurance Service (NHIS) cancer screening in 2009 and health check-ups in 2017 were analyzed. Multivariate logistic regression analyses were used to assess the effect of independent variables of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in 2009, on dependent variable IFG in 2017. After adjusting for potential confounders, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of developing IFG were analyzed. In the premenopausal group, the OR of obese BMI (≥25 kg/m2, <30 kg/m2) women was increased to 2.228 (95% CI: 2.139−2.321) compared to the normal BMI (≥18.5, <23 kg/m2) women as a reference. In the postmenopausal group, there was also a higher OR of 1.778 (95% CI: 1.715−1.843) in the obese BMI women compared to the normal group. A similar association of increasing ORs for IFG was shown in both groups when stratified by WC and WHtR. This nationwide study revealed that obesity and abdominal obesity, defined by various obesity indicators, consistently increased odds of acquiring IFG after 8 years in both pre- and postmenopausal groups, with the association being more robust in the premenopausal group. Our findings suggest that weight management and lifestyle modification may require more attention in premenopausal women.

Association between Health-Related Physical Fitness and Risk of Dyslipidemia in University Staff: A Cross-Sectional Study and a ROC Curve Analysis

Background: This study aimed to assess the relationship between dyslipidemia (DL) risk and health-related physical fitness (HPF) and evaluated the prognostic value of HPF for risk of DL. Methods: A total of 776 university staff members were recruited, of which 407 were females, and 369 males. Blood samples and HPF tests were collected from all participants after 12 h fasting. Results: The prevalence of DL was 41.77% and 51.49% in female and male university staff members, respectively, and there was no significant difference between genders (χ2 = 2.687, p = 0.101). According to the logistic regression analysis, age, male sex, GLU, hypertension, BMI, BF, WHtR, and LAP were significant risk factors for DL (p < 0.05), VCI and, SAR were significant protective factors for DL (p < 0.05), and SMI, GS, and VG were not significantly associated with the risk of DL. The area under the receiver-operating characteristic (ROC) curve (AUC) analysis indicated that, LAP (AUC: 0.730, 95CI%: 0.697–0.762), WHtR (AUC: 0.626, 95CI%: 0.590–0.660), and BMI (AUC: 0.599, 95CI%: 0.563–0.634) are valid predictors of DL, and LAP and WHtR perform better than BMI (Z = 8.074, p < 0.001) in predicting DL in male and female university staff members. Conclusion: The risk of DL is significantly related to body composition, cardiorespiratory fitness, and flexibility. LAP and WHtR perform better than BMI in predicting risk of DL in male and female university staff members.

Fasting Blood Glucose and HbA1c Correlate With Severity of Coronary Artery Disease in Elective PCI Patients With HbA1c 5.7% to 6.4

Diabetes mellitus, and even prediabetes, has been shown to be independently associated with cardiovascular disease. Our study explored whether the combination of glycosylated hemoglobin (HbA_1c) and fasting blood glucose (FBG) can better assess the severity of coronary heart disease (CHD) in elective percutaneous coronary intervention (PCI) patients. We consecutively enrolled 1006 prediabetic patients with HbA_1c 5.7% to 6.4% who underwent elective PCI. Patients were divided into 2 groups: a normal fasting glucose (NFG) group (FBG <6.1 mmol/L) and an impaired fasting glucose (IFG) group (6.1 ≤FBG<7.0 mmol/L) with defined values. Baseline characteristics and angiography data of the 2 groups were compared. The prevalence of 3-vessel disease (P = .002), the GENSINI (the score is named after a professor) score (P = .002), and the SYNTAX (SYNergy between PCI with TAXUS™ and Cardiac Surgery) score (P = .002) of the IFG group was significantly higher compared to the NFG group. After multiple regression analysis, FBG was found to be independently associated with prevalence of 3-vessel disease (adjusted odds ratio: 1.62; 95% confidence interval: 1.21-2.36; P = .013), the GENSINI score (standardized β = .138, P = .008), and the SYNTAX score (standardized β = .145, P = .005). In addition, HbA_{1 c} was independently associated with the prevalence of 3-vessel disease, the GENSINI, score, and the SYNTAX score (P < .05). Both FBG and HbA_1c are independently correlated with the severity of CHD in prediabetic patients with HbA_1c 5.7% to 6.4%.

Components and Risk Factors of Metabolic Syndrome among Rural Nigerian Workers

Background:

Metabolic syndrome (MetS) is a serious public health risk predisposing the workforce to cardiovascular diseases and diabetes.

Aim:

The aim of this study was to determine the components and risk factors of MetS among Nigerian teachers and bank workers (BWs).

Settings and Design:

The cross-sectional study was conducted in Idemili South Local Government Area, Southeast Nigeria.

Materials and Methods:

The study involved 427 teachers and 66 BWs in 14 secondary schools and 5 microfinance banks, respectively. Data collection methods included questionnaire, lipid profile, fasting plasma glucose (FPG), weight, height, waist circumference, and blood pressure (BP) measurements. Inferential statistical analysis involved Pearson correlation and Chi square with Cochran–Mantel–Haenszel test. Significance was accepted at P < 0.05.

Results:

Most (73.3%) of the teachers were 40–60-year-olds; 75.8% of BWs were 19–39-year-olds (P < 0.01). Underweight (7.7%), overweight (26.8%), obesity (17.2%), impaired FPG (IFPG) (14.0%), hypertriglyceridemia (38.0%), and hypertension (40.0%) were prevalent with similarity (P > 0.05) between occupations, age, and gender. Females were more likely to have abdominal obesity (P < 0.01) than males. MetS prevalence was 20%. MetS was more likely among females (odds ratio [OR] =0.63, 95% confidence interval [CI] =0.471–0.841); workers with abdominal obesity (OR = 1.67, 95% CI = 1.210–2.295), IFPG (OR = 0.05, 95% CI = 0.008–0.347), raised diastolic BP (OR = 12.00, 95% CI = 2.177–66.134), and hypertriglyceridemia (OR = 1.55, 95% CI = 1.931–5.600); and those who often drank fluids other than water (OR = 0.11, 95% CI = 0.013–0.961).

Conclusion:

MetS was a problem of public health significance among the workers with higher prevalence among teachers, 40–60-year-olds, and females. Abdominal obesity was the strongest risk factor of metabolic syndrome among the workers.

Visceral fat mass: is it the link between uric acid and diabetes risk?

BACKGROUND

Uric acid (UA) has been suggested as a novel risk factor for diabetes. However, its definite role in this prevalent disease is still the subject of much discussion because it is always accompanied with other major risk factors such as obesity and high visceral adiposity. In order to clarify the role of UA in diabetes, this study aimed to investigate the associations between plasma UA and fasting plasma glucose, HbA1c, lipid profile and inflammatory markers after accounting for the contribution of other diabetes risk factors such as BMI and VAT fat mass.

METHODS

In the present cross-sectional study, 100 non-diabetic middle-aged males (n = 48) and females (n = 52) were recruited. Central fat distribution measures including android to gynoid fat ratio, VAT and subcutaneous adipose tissue (SAT) fat mass were determined using dual-energy X-ray absorptiometry (DXA). Biochemical analysis was done using methods well established for clinical and research laboratories. Multiple linear regression analysis was performed to analyse the association between plasma UA and the biochemical and central fat distribution measures.

RESULTS

UA was positivly associated with body mass index (BMI) (r (98) = 0.42, P ≤ 0.001), android to gynoid fat ratio (r (98) = 0.62, P ≤ 0.001) and VAT fat mass (r (96) = 0.55, P ≤ 0.001). UA was also positively associated with plasma glucose (r (98) = 0.33, P ≤ 0.001), hemoglobin A1c (r (93) = 0.25, P = 0.014), plasma triglyceride (r _s (95) = 0.40, P ≤ 0.001), HDL cholesterol (r (98) = - 0.61, P ≤ 0.001) and CRP (r _s (98) = 0.23, P = 0.026). However, these associations were no longer significant after accounting for BMI or/and VAT fat mass. No significant association was observed between UA and SAT fat mass (r (97) = 0.02, P ≥ 0.05), Total cholesterol (r (98) = 0.03, P ≥ 0.05), LDL cholesterol (r (98) = 0.13, P ≥ 0.05), TNF-α (r (97) = 0.12, P ≥ 0.05) and IL-6 (r (96) = -0.02, P ≥ 0.05).

CONCLUSION

Results from this study suggest, for the first time, that the association between plasma UA and glucose in a non-diabetic population is not direct but rather dependent on VAT fat mass.

Effects of AMPD1 gene C34T polymorphism on cardiac index, blood pressure and prognosis in patients with cardiovascular diseases: a meta-analysis

Background

The meta-analysis was aimed to evaluate the effects of AMPD1 gene C34T polymorphism on cardiac function indexes, blood pressure and prognosis in patients with cardiovascular diseases (CVD).

Methods

Eligible studies were retrieved through a comprehensive search of electronic databases and manual search. Then the high-quality studies met the rigorous inclusion and exclusion criteria, as well as related to the subject was selected for the study. Comprehensive data analyses were conducted using STATA software 12.0.

Results

The study results revealed that CVD patients with CT + TT genotype of AMPD1 C34T polymorphism presented elevated left ventricular ejection fraction (LVEF) (%) and reduced left ventricular end diastolic dimension (LVEDD) (mm) as compared with CC genotype, moreover, the subgroup analysis found that the LVEF (%) was markedly higher in heart failure (HF) patients carrying CT + TT genotype than CC genotype. Besides, the systolic blood pressure (SBP) (mmHg) in CVD patients with CT + TT genotype was obviously decreased in contrast with the CC genotype. Patients suffered from HF with different genotypes (CT + TT and CC) of AMPD1 C34T polymorphism exhibited no significant differences in total survival rate and cardiac survival rate.

Conclusions

Our current meta-analysis indicated that the T allele of AMPD1 gene C34T polymorphism may be correlated with LVEF, LVEDD and SBP, which plays a protective role in the cardiac functions and blood pressure in CVD patients, but had no effects on total survival rate and cardiac survival rate for HF.

Associations Between Sleep Habits and Dysglycemia in Adults in the United States: A Cross-Sectional Analysis

OBJECTIVES

To examine the independent and joint associations between sleep duration and quality with glycated hemoglobin (A1C) levels and dysglycemia in non-institutionalized adults living in the United States.

METHODS

Data from the United States National Health and Nutrition Examination Survey (2005-2008) were used (N=9478; ≥20 years). Information on sleep quantity and quality were derived from the Sleep Disorders Questionnaire and used to classify sleep quality as good, fair, poor, or very poor.

RESULTS

Overall, sleep quantity and quality were related to A1C levels in our unadjusted models. In general, a U-shaped relationship between sleep quantity and A1C levels was observed. Compared to those who slept for 7 to 8 hours per night, sleeping for 4 hours or fewer was associated with higher A1C levels (mean, 95% CI; 5.49%, 5.45 to 5.53 vs. 5.69%, 5.60 to 5.77; p<0.05), whereas only those reporting good and very poor sleep quality had higher A1C levels than poor sleepers (mean, 95% CI: 5.63%, 5.57 to 5.69; 5.56%, 5.52 to 5.60 vs. 5.46%, 5.42 to 5.50; p<0.05). The relationships among sleep duration and quality and the joint effects of sleep quality and quantity and dysglycemia were not significant after multivariable adjustment.

CONCLUSIONS

Between 7 and 8 hours of sleep and fair/poor sleep quality were associated with optimal A1C levels, while sleeping for fewer or more hours appeared to increase dysglycemia, without adjustment for covariates. These relationships were attenuated following multivariable adjustment. Future research is necessary to refine our understanding of the sleep/glycemic-control relationship to provide a context for the clinical significance of these findings for longer-term A1C control in adults with diabetes.

The Association Between Obesity and Hostility: The Mediating Role of Plasma Lipids

OBJECTIVE

Recent research indicates an association between obesity and psychopathology status, the nature of which remains unclear. We evaluated the mediating role of biochemical disturbances in this association among a treatment-seeking sample of obese individuals.

METHOD

The study enrolled 143 consecutive overweight and obese individuals (mean age 35±9 y) and 143 normal-weight controls (mean age 34±9 y), matched by age and sex. We measured psychopathology features using the Symptom Checklist 90-Revised (SCL-90-R), a standardized self-evaluation rating scale, and biochemical parameters (plasma cholesterol, triglyceride, and fasting glucose levels) of all participants. Nonlinear regression models were used to estimate the associations among obesity, psychopathology, and biochemical factors.

RESULTS

Obesity was associated positively and significantly (P<0.05) with all of the SCL-90-R subscales, with the exception of anxiety and phobic anxiety, as well as with levels of plasma glucose, cholesterol (P<0.01), and triglycerides (P<0.001). Tests for mediation showed that obesity was significantly associated, for the mediators of plasma cholesterol [parameter estimate=-0.033, P<0.05] and triglycerides (parameter estimate=-0.059, P<0.05), only with hostility (parameter estimate=-0.024, P<0.05 and parameter estimate=-0.041, P<0.05, respectively).

CONCLUSIONS

Our data suggest that biological substrates that are critically related to obesity, such as dyslipidemia, may mediate, at least in part, the association between obesity and hostility.

Visceral Fat Mass Has Stronger Associations with Diabetes and Prediabetes than Other Anthropometric Obesity Indicators among Korean Adults

PURPOSE

This study determined which obesity measurement correlates the best with diabetes and prediabetes.

MATERIALS AND METHODS

This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines.

RESULTS

After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity.

CONCLUSION

Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.

The characteristics of pre-diabetic patients associated with body composition and cardiovascular disease risk factors in the Iranian population

Background:

Different populations have shown various patterns of association between impaired fasting glucose (IFG) and body composition parameters and risk factors of cardiovascular disease (CVD). The current study aimed at investigating the differences between persons with prediabetes and healthy people in terms of CVD risk factors including body composition parameters, blood pressure, and lipid profile in a sample of the Iranian population.

Materials and Methods:

In a case-control setting, a sample containing 386 (193 prediabetic subjects and 193 normal subjects) of the first-degree relatives of diabetic patients aged 35-55 years were investigated. Samples were assessed using glucose tolerance categories. Prediabetes was defined according to the American Diabetes Association (ADA) criteria. Body composition parameters, blood pressure, glucose parameters, and lipid profile were measured and compared between the two groups.

Results:

Prediabetic patients had higher body mass index (BMI), waist circumference (WC), and body fat (BF) in comparison to the control group (P < 0.05). In addition, prediabetic subject had a higher intake of energy, carbohydrate, protein, fat, and cholesterol and it seems that these patients had an unhealthy dietary intake (P < 0.05). Fasting blood glucose (FBG) (P < 0.001), total cholesterol (P = 0.007), low-density lipoprotein cholesterol (LDL-C), and triglyceride (P = 0.021) were higher in prediabetic patients (P < 0.05) than in the controls.

Conclusion:

Both the risk factors of CVD and body composition parameters were different between the prediabetic and normal groups; total cholesterol (TC), triglyceride (TG), and FBS were predictors of the risk of prediabetes.

Differences of prevalence of dyslipidemia and risk factors related to LDL-c in the patients with abnormal fasting glucose between Uygur and Han in Xinjiang

AIMS

To evaluate the incidence of dyslipidemia among Uygur and Han patients with impaired fasting glucose (IFG). To investigate the influence factors on LDL-c in this population.

METHODS

This cross-sectional study included a total of 4709 participants, consisting of Uygurs patients (n=2053) and Han patients (n=2656) from Xinjiang province, who were screened for diabetes mellitus. A stratified multistage sampling design was used to collect the participants. The influence factors on LDL-c were analyzed by Logistic regression analysis.

RESULTS

Among the IFG patients (n=1757), Uighur IFG group had a higher prevalence of dyslipidemia than that of Han IFG group, 99.8% vs. 63.7%, P<0.05. Similar trends were existed in the prevalence of hypercholesteremia, hypertriglyceridemia, high LDL-c and low HDL-c (all P<0.05). Among the Uighur groups, IFG group had higher dyslipidemia rate than that of euglycemia group (74%). However, there was no such difference in the Han groups. Logistic regression analysis revealed that risk factors associated with LDL-c were age, total cholesterol and 2 h postprandial blood glucose for the Uighur IFG patients. However, gender and total cholesterol were risk factors for Han IFG patients.

CONCLUSIONS

Uighur IFG patients had higher incidence of dyslipidemia than that of Han IFG patients. For Uyghur IFG patients, closing follow-up of total cholesterol and 2 h postprandial blood glucose were necessary. As to the Han IFG patients, we should pay more attention to male and total cholesterol in order to lower LDL-c levels. So, appropriately preventive and therapeutic measures should be chosen based on the characteristics of abnormal lipid profiles in different nationality.

Epidemiology of abnormal glucose metabolism in a country facing its epidemic: SAUDI-DM study

BACKGROUND

Saudi Arabia is a community thrilled by sudden social and economical changes, leading to a sharp increase in the prevalence of abnormal glucose metabolism. Age-specific diabetes and impaired fasting glucose prevalence is the focus of this study with the expected risk factors.

METHODS

A nationwide, household, randomized, population based cohort of 18 034 participants aged ≥30 years was selected to test for abnormal glucose metabolism using fasting plasma glucose (FPG) according to American Diabetes Association (ADA) criteria.

RESULTS

The prevalence of diabetes was 25.4% with 40.3% being unaware of their disease, while impaired fasting glucose (IFG) affected 25.5% of the total sample. IFG to diabetes ratio was one in this study, decreasing with age and increasing with body weight. Age ≥45 years, hypertension, history of gestational diabetes mellitus (GDM), and high triglycerides are the strongest risk factors in diabetic patients, while history of GDM, dyslipidemia, obesity, and high triglycerides are the most significant risk factors in IFG participants.

CONCLUSIONS

Abnormal glucose metabolism has reached an epidemic level in this society, where half of adults and older are affected. Risk factors are behind this epidemic and the quick shift from IFG to diabetes in this society.

Developing discriminate model and comparative analysis of differentially expressed genes and pathways for bloodstream samples of diabetes mellitus type 2

Background

Diabetes mellitus of type 2 (T2D), also known as noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, is a common disease. It is estimated that more than 300 million people worldwide suffer from T2D. In this study, we investigated the T2D, pre-diabetic and healthy human (no diabetes) bloodstream samples using genomic, genealogical, and phonemic information. We identified differentially expressed genes and pathways. The study has provided deeper insights into the development of T2D, and provided useful information for further effective prevention and treatment of the disease.

Results

A total of 142 bloodstream samples were collected, including 47 healthy humans, 22 pre-diabetic and 73 T2D patients. Whole genome scale gene expression profiles were obtained using the Agilent Oligo chips that contain over 20,000 human genes. We identified 79 significantly differentially expressed genes that have fold change ≥ 2. We mapped those genes and pinpointed locations of those genes on human chromosomes. Amongst them, 3 genes were not mapped well on the human genome, but the rest of 76 differentially expressed genes were well mapped on the human genome. We found that most abundant differentially expressed genes are on chromosome one, which contains 9 of those genes, followed by chromosome two that contains 7 of the 76 differentially expressed genes. We performed gene ontology (GO) functional analysis of those 79 differentially expressed genes and found that genes involve in the regulation of cell proliferation were among most common pathways related to T2D. The expression of the 79 genes was combined with clinical information that includes age, sex, and race to construct an optimal discriminant model. The overall performance of the model reached 95.1% accuracy, with 91.5% accuracy on identifying healthy humans, 100% accuracy on pre-diabetic patients and 95.9% accuract on T2D patients. The higher performance on identifying pre-diabetic patients was resulted from more significant changes of gene expressions among this particular group of humans, which implicated that patients were having profound genetic changes towards disease development.

Conclusion

Differentially expressed genes were distributed across chromosomes, and are more abundant on chromosomes 1 and 2 than the rest of the human genome. We found that regulation of cell proliferation actually plays an important role in the T2D disease development. The predictive model developed in this study has utilized the 79 significant genes in combination with age, sex, and racial information to distinguish pre-diabetic, T2D, and healthy humans. The study not only has provided deeper understanding of the disease molecular mechanisms but also useful information for pathway analysis and effective drug target identification.

Influence of a ketogenic diet, fish-oil, and calorie restriction on plasma metabolites and lipids in C57BL/6J mice

BACKGROUND

Diet therapies including calorie restriction, ketogenic diets, and fish-oil supplementation have been used to improve health and to treat a variety of neurological and non-neurological diseases.

METHODS

We investigated the effects of three diets on circulating plasma metabolites (glucose and β-hydroxybutyrate), hormones (insulin and adiponectin), and lipids over a 32-day period in C57BL/6J mice. The diets evaluated included a standard rodent diet (SD), a ketogenic diet (KD), and a standard rodent diet supplemented with fish-oil (FO). Each diet was administered in either unrestricted (UR) or restricted (R) amounts to reduce body weight by 20%.

RESULTS

The KD-UR increased body weight and glucose levels and promoted a hyperlipidemic profile, whereas the FO-UR decreased body weight and glucose levels and promoted a normolipidemic profile, compared to the SD-UR. When administered in restricted amounts, all three diets produced a similar plasma metabolite profile, which included decreased glucose levels and a normolipidemic profile. Linear regression analysis showed that circulating glucose most strongly predicted body weight and triglyceride levels, whereas calorie intake moderately predicted glucose levels and strongly predicted ketone body levels.

CONCLUSIONS

These results suggest that biomarkers of health can be improved when diets are consumed in restricted amounts, regardless of macronutrient composition.

The prevalence and determinants of impaired fasting glucose in the population of Taiwan

BACKGROUND

A current prevalence and relevant risk factors for impaired fasting glucose (IFG) have been reported by various ethnic groups and countries. By contrast, nationwide data for the incidence of IFG in Taiwan have not been presented in the past 15 years. The aim for this manuscript was to estimate the prevalence of IFG and associated risk factors in the population of Taiwan.

METHODS

For this cross-sectional research, we used a nationally representative sample (N = 2604) obtained from the 2005-2008 Nutrition and Health Survey in Taiwan (NAHSIT), and adopted a stratified multistage sampling design. The tools employed for data collection included questionnaire interviews, anthropometry measurements, and laboratory analysis.

RESULTS

The prevalence of IFG among adults in Taiwan is 35.8% (a fasting glucose level between 100 and 125 mg/dl is considered abnormal). An estimated number of people with IFG is 6.5 million. A higher prevalence of IFG is observed in men younger than 65 years compared to women. However, this trend is reversed for the elderly population. The factors significantly associated with IFG include the following: sex, age, overweight (27 > BMI ≥ 24), obesity (BMI ≥ 27), waist circumference (men ≥ 90 cm, women ≥ 80 cm), hypertension, and hyperlipidemia.

CONCLUSIONS

IFG among adults in Taiwan is a health concern that requires attention. We recommend targeting the younger population, especially overweight and obese men between the ages of 19 and 40 years, to provide applicable healthy lifestyle counseling and services. Furthermore, appropriate screening of elderly people is required to detect undiagnosed IFG cases and provide early intervention and treatment.

Waist-to-height ratio is the best indicator for undiagnosed type 2 diabetes

AIMS

Early detection of diabetes is important for the prevention of diabetic complications. The best adiposity index for indicating Type 2 diabetes mellitus remains unclear. We aimed to identify the optimal adiposity measure among BMI, waist circumference, waist-hip ratio and waist-to-height ratio to indicate undiagnosed Type 2 diabetes and impaired fasting glucose in Chinese adults.

METHODS

A total of 7567 participants aged 20-79 years were included in this study. Impaired fasting glucose was defined as a fasting plasma glucose level of 6.1-6.9 mmol/l in participants without diabetes. Undiagnosed Type 2 diabetes was identified as fasting plasma glucose ≥ 7.0 mmol/l when neither a history of diabetes nor use of hypoglycaemic drugs was present. Body weight, height, waist and hip circumferences were measured following standard procedures. Data were analysed using logistic regression and areas under the receiver operating characteristic curves.

RESULTS

Of the 7567 participants, 536 were defined as having impaired fasting glucose and 690 were patients with Type 2 diabetes, including 290 (3.8%) persons with undiagnosed diabetes. In multivariate logistic regression, the odds ratios of waist-to-height ratio (≥ 0.5) were stronger than BMI (≥ 24 kg/m²), waist circumference (≥ 85 cm in men and ≥ 80 cm in women) and waist-hip ratio (≥ 0.85) for undiagnosed Type 2 diabetes and impaired fasting glucose. Among the four indices, waist-to-height ratio ≥ 0.5 showed the largest area under the receiver operating characteristic curve for diagnosing undiagnosed Type 2 diabetes (0.725, 95% CI 0.693-0.756) and impaired fasting glucose (0.662, 95% CI 0.638-0.687).

CONCLUSIONS

By comparison with BMI, waist circumference and waist-hip ratio, waist-to-height ratio ≥ 0.5 may be the best indicator for undiagnosed Type 2 diabetes and impaired fasting glucose.

Adiponectin is Associated with Impaired Fasting Glucose in the Non-Diabetic Population

OBJECTIVES

Adiponectin is strongly associated with diabetes in the Western population. However, whether adiponectin is independently associated with impaired fasting glucose (IFG) in the non-obese population is unknown.

METHODS

The serum adiponectin, insulin resistance (IR), and waist circumference (WC) of 27,549 healthy Koreans were measured. Individuals were then classified into tertile groups by gender. IFG was defined as a fasting serum glucose of 100-125 mg/dL without diabetes. IR was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR). The association of adiponectin and IFG was determined using logistic regression analysis.

RESULTS

WC and adiponectin were associated with IFG in both men and women. However, the association of WC with IFG was attenuated in both men and women after adjustment for the HOMA-IR. Adiponectin was still associated with IFG after adjustment for and stratification by HOMA-IR in men and women. Strong combined associations of IR and adiponectin with IFG were observed in men and women. Multivariate adjusted odds ratios (ORs) (95% confidence interval [CI]) among those in the highest tertile of IR and the lowest tertile of adiponectin were 9.8 (7.96 to 12.07) for men and 24.1 (13.86 to 41.94) for women.

CONCLUSION

These results suggest that adiponectin is strongly associated with IFG, and point to adiponectin as an additional diagnostic biomarker of IFG in the non-diabetic population.