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Hawes EM, Rahim M, Haratipour Z, Orun AR, O'Rourke ML, Oeser JK, Kim K, Claxton DP, Blind RD, Young JD, O'Brien RM. Biochemical and metabolic characterization of a G6PC2 inhibitor. Biochimie 2024; 222:109-122. [PMID: 38431189 DOI: 10.1016/j.biochi.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
Three glucose-6-phosphatase catalytic subunits, that hydrolyze glucose-6-phosphate (G6P) to glucose and inorganic phosphate, have been identified, designated G6PC1-3, but only G6PC1 and G6PC2 have been implicated in the regulation of fasting blood glucose (FBG). Elevated FBG has been associated with multiple adverse clinical outcomes, including increased risk for type 2 diabetes and various cancers. Therefore, G6PC1 and G6PC2 inhibitors that lower FBG may be of prophylactic value for the prevention of multiple conditions. The studies described here characterize a G6PC2 inhibitor, designated VU0945627, previously identified as Compound 3. We show that VU0945627 preferentially inhibits human G6PC2 versus human G6PC1 but activates human G6PC3. VU0945627 is a mixed G6PC2 inhibitor, increasing the Km but reducing the Vmax for G6P hydrolysis. PyRx virtual docking to an AlphaFold2-derived G6PC2 structural model suggests VU0945627 binds two sites in human G6PC2. Mutation of residues in these sites reduces the inhibitory effect of VU0945627. VU0945627 does not inhibit mouse G6PC2 despite its 84% sequence identity with human G6PC2. Mutagenesis studies suggest this lack of inhibition of mouse G6PC2 is due, in part, to a change in residue 318 from histidine in human G6PC2 to proline in mouse G6PC2. Surprisingly, VU0945627 still inhibited glucose cycling in the mouse islet-derived βTC-3 cell line. Studies using intact mouse liver microsomes and PyRx docking suggest that this observation can be explained by an ability of VU0945627 to also inhibit the G6P transporter SLC37A4. These data will inform future computational modeling studies designed to identify G6PC isoform-specific inhibitors.
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Affiliation(s)
- Emily M Hawes
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Mohsin Rahim
- Department of Chemical and Biomolecular Engineering, Vanderbilt School of Engineering, Nashville, TN, 37232, USA
| | - Zeinab Haratipour
- Austin Peay State University, 601 College St, Clarksville, TN 37044, USA; Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Abigail R Orun
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Margaret L O'Rourke
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - James K Oeser
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Kwangho Kim
- Department of Chemistry, Vanderbilt Institute of Chemical Biology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Derek P Claxton
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Ray D Blind
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Jamey D Young
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA; Department of Chemical and Biomolecular Engineering, Vanderbilt School of Engineering, Nashville, TN, 37232, USA
| | - Richard M O'Brien
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA.
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Yousef H, Feng SF, Jelinek HF. Exploratory risk prediction of type II diabetes with isolation forests and novel biomarkers. Sci Rep 2024; 14:14409. [PMID: 38909127 PMCID: PMC11193708 DOI: 10.1038/s41598-024-65044-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024] Open
Abstract
Type II diabetes mellitus (T2DM) is a rising global health burden due to its rapidly increasing prevalence worldwide, and can result in serious complications. Therefore, it is of utmost importance to identify individuals at risk as early as possible to avoid long-term T2DM complications. In this study, we developed an interpretable machine learning model leveraging baseline levels of biomarkers of oxidative stress (OS), inflammation, and mitochondrial dysfunction (MD) for identifying individuals at risk of developing T2DM. In particular, Isolation Forest (iForest) was applied as an anomaly detection algorithm to address class imbalance. iForest was trained on the control group data to detect cases of high risk for T2DM development as outliers. Two iForest models were trained and evaluated through ten-fold cross-validation, the first on traditional biomarkers (BMI, blood glucose levels (BGL) and triglycerides) alone and the second including the additional aforementioned biomarkers. The second model outperformed the first across all evaluation metrics, particularly for F1 score and recall, which were increased from 0.61 ± 0.05 to 0.81 ± 0.05 and 0.57 ± 0.06 to 0.81 ± 0.08, respectively. The feature importance scores identified a novel combination of biomarkers, including interleukin-10 (IL-10), 8-isoprostane, humanin (HN), and oxidized glutathione (GSSG), which were revealed to be more influential than the traditional biomarkers in the outcome prediction. These results reveal a promising method for simultaneously predicting and understanding the risk of T2DM development and suggest possible pharmacological intervention to address inflammation and OS early in disease progression.
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Affiliation(s)
- Hibba Yousef
- Biotechnology Research Center, Technology Innovation Institute, Masdar City, P. O. Box 9639, Abu Dhabi, United Arab Emirates.
| | - Samuel F Feng
- Department of Science and Engineering, Sorbonne University Abu Dhabi, Abu Dhabi, United Arab Emirates
- SUAD Research Institute, Sorbonne University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Herbert F Jelinek
- Department of Medical Sciences, Khalifa University, 127788, Abu Dhabi, United Arab Emirates
- Biotechnology Center, Khalifa University, 127788, Abu Dhabi, United Arab Emirates
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Lee MK, Han K, Kim B, Kim JD, Jung Kim M, Kim B, Heo J, Ahn J, Sohn SY, Lee JH. Cumulative exposure to hypertriglyceridemia and risk of type 2 diabetes in young adults. Diabetes Res Clin Pract 2024; 208:111109. [PMID: 38262520 DOI: 10.1016/j.diabres.2024.111109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
AIM This study aimed to examine whether cumulative exposure to hypertriglyceridemia is associated with an increased risk of developing type 2 diabetes in young adults. METHODS The study included 1,840,251 participants aged 20-39 years who had undergonefourconsecutiveannualhealth checkups and had no history of type 2 diabetes. Participants werecategorized into five groups (exposure score 0-4) based on the frequencies of hypertriglyceridemia diagnosis over a four-year period. The primary outcome was newly diagnosed type 2 diabetes. Exploratory analyses were performed for the different subgroups. RESULTS During a follow-up period of 6.53 years, 40,286 participants developed type 2 diabetes. The cumulative incidence of type 2 diabetes significantly increased with higher exposure scores for hypertriglyceridemia (log-rank test, P < 0.001). The multivariable-adjusted hazard ratios for incident diabetes were 1.674 (95 % CI, 1.619, 1.732), 2.192 (95 % CI, 2.117, 2.269), 2.637 (95 % CI, 2.548, 2.73), and 3.715 (95 % CI, 3.6, 3.834) for participants with scores of 1-4, respectively, compared with those with an exposure score of 0. CONCLUSIONS In this large-scale prospective cohort study of young adults, cumulative exposure to hypertriglyceridemia was significantly associated with an increased risk of type 2 diabetes, independent of lifestyle-related factors.
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Affiliation(s)
- Min-Kyung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea.
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Bongsung Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jong-Dai Kim
- Division of Endocrinology, Department of Internal Medicine, Konayng University Hospital, Daejeon, Republic of Korea
| | - Moon Jung Kim
- Department of Laboratory Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Byungpyo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jung Heo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jiyeon Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Seo-Young Sohn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jae-Hyuk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
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Tsai WY, Breimann S, Shen TW, Frishman D. Photoacoustic and absorption spectroscopy imaging analysis of human blood. PLoS One 2023; 18:e0289704. [PMID: 37540721 PMCID: PMC10403132 DOI: 10.1371/journal.pone.0289704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/25/2023] [Indexed: 08/06/2023] Open
Abstract
Photoacoustic and absorption spectroscopy imaging are safe and non-invasive molecular quantification techniques, which do not utilize ionizing radiation and allow for repeated probing of samples without them being contaminated or damaged. Here we assessed the potential of these techniques for measuring biochemical parameters. We investigated the statistical association between 31 time and frequency domain features derived from photoacoustic and absorption spectroscopy signals and 19 biochemical blood parameters. We found that photoacoustic and absorption spectroscopy imaging features are significantly correlated with 14 and 17 individual biochemical parameters, respectively. Moreover, some of the biochemical blood parameters can be accurately predicted based on photoacoustic and absorption spectroscopy imaging features by polynomial regression. In particular, the levels of uric acid and albumin can be accurately explained by a combination of photoacoustic and absorption spectroscopy imaging features (adjusted R-squared > 0.75), while creatinine levels can be accurately explained by the features of the photoacoustic system (adjusted R-squared > 0.80). We identified a number of imaging features that inform on the biochemical blood parameters and can be potentially useful in clinical diagnosis. We also demonstrated that linear and non-linear combinations of photoacoustic and absorption spectroscopy imaging features can accurately predict some of the biochemical blood parameters. These results demonstrate that photoacoustic and absorption spectroscopy imaging systems show promise for future applications in clinical practice.
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Affiliation(s)
- Wei-Yun Tsai
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Freising, Germany
| | - Stephan Breimann
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Freising, Germany
| | - Tsu-Wang Shen
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
- Master's Program Biomedical Informatics and Biomedical Engineering, Feng Chia University, Taichung, Taiwan
| | - Dmitrij Frishman
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Freising, Germany
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Chu N, Chan TY, Chu YK, Ling J, He J, Leung K, Ma RCW, Chan JCN, Chow E. Higher dietary magnesium and potassium intake are associated with lower body fat in people with impaired glucose tolerance. Front Nutr 2023; 10:1169705. [PMID: 37139459 PMCID: PMC10150130 DOI: 10.3389/fnut.2023.1169705] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Obesity and diabetes are public health concerns worldwide, but few studies have examined the habitual intake of minerals on body composition in people with prediabetes. Methods In this prospective cross-sectional study, 155 Chinese subjects with IGT [median age: 59 (53-62) years, 58% female] had an assessment of body composition including body fat percentage, oral glucose tolerance tests (OGTT), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and 3-day food records from nutritional programme analysis. Results Dietary intake of minerals was negatively correlated with body fat. People with obesity had the lowest daily consumption of iron median (IQR) 10.3 (6.9-13.3) mg, magnesium 224 (181-282) mg, and potassium 1973 (1563-2,357) mg when compared to overweight [10.5 (8.0-14.5) mg, 273 (221-335) mg, and 2,204 (1720-2,650) mg] and normal weight individuals [13.2 (10.0-18.6) mg, 313 (243-368) mg, and 2,295 (1833-3,037) mg] (p = 0.008, <0.0001, and 0.013 respectively). Amongst targeted minerals, higher dietary magnesium and potassium intake remained significantly associated with lower body fat after the adjustment of age, gender, macronutrients, fibre, and physical activity. Conclusion Dietary magnesium and potassium intake may be associated with lower body fat in people with impaired glucose tolerance. Inadequate dietary mineral intake may play contribute to obesity and metabolic disorders independent of macronutrients and fibre consumption.
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Affiliation(s)
- Natural Chu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
- *Correspondence: Natural Chu,
| | - Tsz Yeung Chan
- Department of Life Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Yuen Kiu Chu
- Department of Life Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - James Ling
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
| | - Jie He
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
| | - Kathy Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
| | - Ronald C. W. Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
| | - Juliana C. N. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
| | - Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
- Elaine Chow,
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Association between a priori and a posteriori dietary patterns and the risk of type 2 diabetes: a representative cohort study in Taiwan. J Nutr Sci 2023; 12:e16. [PMID: 36843973 PMCID: PMC9947633 DOI: 10.1017/jns.2023.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 02/10/2023] Open
Abstract
The present study aimed to investigate the relationship between dietary patterns and the risk of type 2 diabetes mellitus (T2DM) among Taiwanese individuals. Data were collected using a nationwide cohort study (2001-15) from the Triple-High Database. Dietary intake was assessed using the twenty-group food frequency questionnaire and used to calculate alternate Mediterranean diet (aMED) and Dietary Approaches to Stop Hypertension (DASH) scores. Principal component analysis (PCA) and partial least-squares (PLS) regression were used to derive dietary patterns, with incident T2DM as the outcome. Multivariable-adjusted hazard ratios and 95 % confidence intervals were calculated using time-dependent Cox proportional hazards (Cox PH) regression analysis, and subgroup analyses were performed. A total of 4705 participants were enrolled in the study, and 995 had newly developed T2DM during the median 5⋅28-year follow-up period (30⋅7 per 1000 person-years). Six dietary patterns were extracted (PCA: Western, prudent, dairy and plant-based; PLS: health-conscious, fish-vegetable and fruit-seafood). The highest aMED score quartile had a 25 % (hazard ratio 0⋅75; 95 % CI 0⋅61, 0⋅92; P = 0⋅039) lower risk of T2DM than the lowest quartile. This association remained significant after adjustment (adjusted hazard ratio 0⋅74; 95 % CI 0⋅60, 0⋅91; P = 0⋅010), and no effect modifier was found for aMED. The DASH scores, PCA and PLS dietary patterns were not significant after adjustment. In conclusion, high adherence to a MED-type dietary pattern by Taiwanese foods was associated with a lower risk of T2DM in the Taiwanese population, regardless of unhealthy lifestyle habits.
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Pramono A, Fitranti DY, Nugroho KH, Sobirin MA, Syauqy A. The Association between Unhealthy Food Consumption and Impaired Glucose Metabolism among Adults with Overweight or Obesity: A Cross-Sectional Analysis of the Indonesian Population. J Obes 2023; 2023:2885769. [PMID: 37006782 PMCID: PMC10060072 DOI: 10.1155/2023/2885769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND It has been shown that dietary patterns are associated with glucose control. However, the association between the types of food consumed and blood glucose in overweight or obese individuals is still unclear. The present study aimed to determine the association between unhealthy food consumption and impaired glucose metabolism in adults with overweight or obesity. METHODS The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2018/RISKESDAS 2018). The body mass index (BMI) was calculated as weight (kg)/height squared (m2) and was determined based on the World Health Organization (WHO) criteria for the Asian population. A validated questionnaire and food card were used to assess the diet. Fasting plasma glucose and 2-hpost-prandial glucose were employed to determine blood glucose markers. RESULTS In total, 8752 adults with overweight or obesity were included in this analysis. We found that consumption of sweet, grilled, and processed foods was associated with impaired fasting plasma glucose (IFG) before and after adjustment (p < 0.05). Consumption of high-fat foods was also associated with impaired glucose tolerance (IGT) for all models tested (p < 0.05). Furthermore, all models showed a link between processed food consumption and combined glucose intolerance (CGI) (p ≤ 0.001). CONCLUSIONS Differential food group consumption was associated with IFG, IGT, and CGI in Indonesian adults who were overweight or obese.
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Affiliation(s)
- Adriyan Pramono
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - Deny Y. Fitranti
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - K. Heri Nugroho
- Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - M. Ali Sobirin
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - Ahmad Syauqy
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
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Magkos F, Reeds DN, Mittendorfer B. Evolution of the diagnostic value of "the sugar of the blood": hitting the sweet spot to identify alterations in glucose dynamics. Physiol Rev 2023; 103:7-30. [PMID: 35635320 PMCID: PMC9576168 DOI: 10.1152/physrev.00015.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
In this paper, we provide an overview of the evolution of the definition of hyperglycemia during the past century and the alterations in glucose dynamics that cause fasting and postprandial hyperglycemia. We discuss how extensive mechanistic, physiological research into the factors and pathways that regulate the appearance of glucose in the circulation and its uptake and metabolism by tissues and organs has contributed knowledge that has advanced our understanding of different types of hyperglycemia, namely prediabetes and diabetes and their subtypes (impaired fasting plasma glucose, impaired glucose tolerance, combined impaired fasting plasma glucose, impaired glucose tolerance, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus), their relationships with medical complications, and how to prevent and treat hyperglycemia.
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Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
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Vajravelu ME, Hirschfeld E, Gebremariam A, Burant CF, Herman WH, Peterson KE, Meijer JL, Lee JM. Prospective Test Performance of Nonfasting Biomarkers to Identify Dysglycemia in Children and Adolescents. Horm Res Paediatr 2022; 96:316-324. [PMID: 36380614 PMCID: PMC10183477 DOI: 10.1159/000528043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Test performance screening measures for dysglycemia have not been evaluated prospectively in youth. This study evaluated the prospective test performance of random glucose (RG), 1-h nonfasting glucose challenge test (1-h GCT), hemoglobin A1c (HbA1c), fructosamine (FA), and 1,5-anhydroglucitol (1,5-AG) for identifying dysglycemia. METHODS Youth ages 8-17 years with overweight or obesity (body mass index, BMI, ≥85th percentile) without known diabetes completed nonfasting tests at baseline (n = 176) and returned an average of 1.1 years later for two formal fasting 2-h oral glucose tolerance tests. Outcomes included glucose-defined dysglycemia (fasting plasma glucose ≥100 mg/dL or 2-h plasma glucose ≥140 mg/dL) or elevated HbA1c (≥5.7%). Longitudinal test performance was evaluated using receiver-operating characteristic (ROC) curves and calculation of area under the curve (AUC). RESULTS Glucose-defined dysglycemia, elevated HbA1c, and either dysglycemia or elevated HbA1c were present in 15 (8.5%), 11 (6.3%), and 23 (13.1%) participants at baseline, and 16 (9.1%), 18 (10.3%), and 28 (15.9%) participants at follow-up. For prediction of glucose-defined dysglycemia at follow-up, RG, 1-h GCT, and HbA1c had similar performance (0.68 (95% CI: 0.55-0.80), 0.76 (95% CI: 0.64-0.89), and 0.70 (95% CI: 0.56-0.84)), while FA and 1,5-AG performed poorly. For prediction of HbA1c at follow-up, baseline HbA1c had strong performance (AUC 0.93 [95% CI: 0.88-0.98]), RG had moderate performance (AUC 0.67 [95% CI: 0.54-0.79]), while 1-h GCT, FA, and 1,5-AG performed poorly. CONCLUSION HbA1c and nonfasting glucose tests had reasonable longitudinal discrimination identifying adolescents at risk for dysglycemia, but performance depended on outcome definition.
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Affiliation(s)
- Mary Ellen Vajravelu
- Division of Pediatric Endocrinology, Diabetes and Metabolism, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Emily Hirschfeld
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Acham Gebremariam
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Charles F. Burant
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - William H. Herman
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jennifer L. Meijer
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
- Weight and Wellness Center, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Joyce M. Lee
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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Tamas I, Major E, Horvath D, Keller I, Ungvari A, Haystead TA, MacDonald JA, Lontay B. Mechanisms by which smoothelin-like protein 1 reverses insulin resistance in myotubules and mice. Mol Cell Endocrinol 2022; 551:111663. [PMID: 35508278 DOI: 10.1016/j.mce.2022.111663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
Insulin resistance (InR) is manifested in skeletal muscle by decreased insulin-stimulated glucose uptake due to impaired insulin signaling and multiple post-receptor intracellular defects. Chronic glucose-induced insulin resistance leads to the activation of Ser/Thr kinases and elevated phosphorylation of insulin receptor substrate 1 (IRS1) on Ser residues. Phosphorylation of IRS1 triggers the dissociation of IRS1 and its downstream effector, phosphatidylinositol 3-kinase. In the present study, we provide evidence for the insulin-sensitizing role of smoothelin-like protein 1 (SMTNL1) that is a ligand-dependent co-regulator of steroid receptors, predominantly the progesterone receptor. SMTNL1 was transiently overexpressed in insulin-resistant C2C12 myotubes. A proteome profiler array revealed that mTOR and Ser/Thr kinases were SMTNL1-dependent signaling pathways. In the presence of progesterone, overexpression was coupled to decreased Ser phosphorylation of IRS1 at Ser307, Ser318, and Ser612 residues. SMTNL1 also induced the expression and activity of the p85 subunit of PI3K. SMTNL1 regulated the expression of PKCε, which phosphorylates IRS1 at Ser318 residue. SMTNL1 also regulated ERK1/2 and JNK, which phosphorylate IRS1 at Ser612 and Ser307, respectively. Real-time metabolic measurements of oxygen consumption rate and extracellular acidification rate revealed that SMTNL1 improved glycolysis and promoted the utilization of alternative carbon fuels. SMTNL1 also rescued the mitochondrial respiration defect induced by chronic insulin exposure. Collectively, SMTNL1 plays a crucial role in maintaining the physiological ratio of Tyr/Ser IRS1 phosphorylation and attenuates the insulin-signaling cascade that contributes to impaired glucose disposal, which makes it a potential therapeutic target for improving InR.
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Affiliation(s)
- Istvan Tamas
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Evelin Major
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniel Horvath
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ilka Keller
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Adam Ungvari
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Timothy A Haystead
- Duke University School of Medicine, Department of Pharmacology and Cancer Biology, Durham, NC, USA
| | - Justin A MacDonald
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Beata Lontay
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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11
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King KM, Bevan DR, Brown AM. Molecular Dynamics Simulations Indicate Aromaticity as a Key Factor in the Inhibition of IAPP (20-29) Aggregation. ACS Chem Neurosci 2022; 13:1615-1626. [PMID: 35587203 DOI: 10.1021/acschemneuro.2c00025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Islet amyloid polypeptide (IAPP) is a 37-residue amyloidogenic hormone implicated in the progression of Type II Diabetes (T2D). T2D affects an estimated 422 million people yearly and is a comorbidity with numerous diseases. IAPP forms toxic oligomers and amyloid fibrils that reduce pancreatic β-cell mass and exacerbate the T2D disease state. Toxic oligomer formation is attributed, in part, to the formation of interpeptide β-strands comprised of residues 20-29 (IAPP(20-29)). Flavonoids, a class of polyphenolic natural products, have been found experimentally to inhibit IAPP aggregate formation. Many of these small flavonoids differ structurally only slightly; the influence of functional group placement on inhibiting the aggregation of the IAPP(20-29) has yet to be explored. To probe the role of small-molecule structural features that impede IAPP aggregation, molecular dynamics simulations were performed to observe trimer formation on a model fragment of IAPP(20-29) in the presence of morin, quercetin, dihydroquercetin, epicatechin, and myricetin. Contacts between Phe23 residues were critical to oligomer formation, and small-molecule contacts with Phe23 were a key predictor of β-strand reduction. Structural properties influencing the ability of compounds to disrupt Phe23-Phe23 contacts included aromaticity and carbonyl and hydroxyl group placement. This work provides key information on design considerations for T2D therapeutics that target IAPP aggregation.
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Affiliation(s)
- Kelsie M King
- Department of Biochemistry, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - David R Bevan
- Department of Biochemistry, Virginia Tech, Blacksburg, Virginia 24061, United States
- Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Anne M Brown
- Department of Biochemistry, Virginia Tech, Blacksburg, Virginia 24061, United States
- Research and Informatics, University Libraries, Virginia Tech, Blacksburg, Virginia 24061, United States
- Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
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12
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Xiao Y, Li K, Bian J, Liu H, Zhai X, El‐Omar E, Han L, Gong L, Wang M. Urolithin A attenuates diabetes‐associated cognitive impairment by ameliorating intestinal barrier dysfunction via N‐glycan biosynthesis pathway. Mol Nutr Food Res 2022; 66:e2100863. [DOI: 10.1002/mnfr.202100863] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/24/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Yao Xiao
- College of Food Science and Engineering Northwest A & F University Yangling Shaanxi 712100 China
| | - Kailin Li
- College of Food Science and Engineering Northwest A & F University Yangling Shaanxi 712100 China
| | - Ji Bian
- Kolling Institute Sydney Medical School Royal North Shore Hospital University of Sydney St. Leonards NSW 2065 Australia
| | - Hang Liu
- School of Life Sciences and Biotechnology Shanghai Jiao Tong University Shanghai Center for Systems Biomedicine Shanghai 200240 China
| | - Xiaotong Zhai
- College of Food Science and Engineering Northwest A & F University Yangling Shaanxi 712100 China
- Academy of National Food and Strategic Reserves Administration No.11 Baiwanzhuang Street Beijing 100037 China
| | - Emad El‐Omar
- Microbiome Research Centre St George and Sutherland Clinical School University of New South Wales Sydney Australia
| | - Lin Han
- College of Food Science and Engineering Northwest A & F University Yangling Shaanxi 712100 China
| | - Lan Gong
- Microbiome Research Centre St George and Sutherland Clinical School University of New South Wales Sydney Australia
| | - Min Wang
- College of Food Science and Engineering Northwest A & F University Yangling Shaanxi 712100 China
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13
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Szczerbinski L, Taylor MA, Puchta U, Konopka P, Paszko A, Citko A, Szczerbinski K, Goscik J, Gorska M, Larsen S, Kretowski A. The Response of Mitochondrial Respiration and Quantity in Skeletal Muscle and Adipose Tissue to Exercise in Humans with Prediabetes. Cells 2021; 10:cells10113013. [PMID: 34831236 PMCID: PMC8616473 DOI: 10.3390/cells10113013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Mitochondrial dysfunction has been implicated in the pathogenesis of type 2 diabetes, but its contribution to the early stages of dysglycemia remains poorly understood. By collecting a high-resolution stage-based spectrum of dysglycemia, our study fills this gap by evaluating derangement in both the function and quantity of mitochondria. We sampled mitochondria in skeletal muscle and subcutaneous adipose tissues of subjects with progressive advancement of dysglycemia under a three-month exercise intervention. Methods: We measured clinical metabolic parameters and gathered skeletal muscle and adipose tissue biopsies before and after the three-month exercise intervention. We then assayed the number of mitochondria via citrate synthase (CS) activity and functional parameters with high-resolution respirometry. Results: In muscle, there were no differences in mitochondrial quantity or function at baseline between normoglycemics and prediabetics. However, the intervention caused improvement in CS activity, implying an increase in mitochondrial quantity. By contrast in adipose tissue, baseline differences in CS activity were present, with the lowest CS activity coincident with impaired fasting glucose and impaired glucose tolerance (IFG + IGT). Finally, CS activity, but few of the functional metrics, improved under the intervention. Conclusions: We show that in prediabetes, no differences in the function or amount of mitochondria (measured by CS activity) in skeletal muscle are apparent, but in adipose tissue of subjects with IFG + IGT, a significantly reduced activity of CS was observed. Finally, metabolic improvements under the exercise correlate to improvements in the amount, rather than function, of mitochondria in both tissues.
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Affiliation(s)
- Lukasz Szczerbinski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (U.P.); (K.S.); (M.G.); (A.K.)
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
- Correspondence: ; Tel.: +48-85-831-8150
| | - Mark Alan Taylor
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, 1450 3rd St., San Francisco, CA 94158, USA
| | - Urszula Puchta
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (U.P.); (K.S.); (M.G.); (A.K.)
| | - Paulina Konopka
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
| | - Adam Paszko
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
| | - Anna Citko
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
| | - Karol Szczerbinski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (U.P.); (K.S.); (M.G.); (A.K.)
| | - Joanna Goscik
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
| | - Maria Gorska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (U.P.); (K.S.); (M.G.); (A.K.)
| | - Steen Larsen
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark
| | - Adam Kretowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (U.P.); (K.S.); (M.G.); (A.K.)
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland; (M.A.T.); (P.K.); (A.P.); (A.C.); (J.G.); (S.L.)
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Khanh VC, Fukushige M, Chang YH, Hoang NN, Yamashita T, Obata-Yasuoka M, Hamada H, Osaka M, Hiramatsu Y, Ohneda O. Wharton's Jelly Mesenchymal Stem Cell-Derived Extracellular Vesicles Reduce SARS-CoV2-Induced Inflammatory Cytokines Under High Glucose and Uremic Toxin Conditions. Stem Cells Dev 2021; 30:758-772. [PMID: 34074129 PMCID: PMC8356045 DOI: 10.1089/scd.2021.0065] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Cytokine storm is recognized as one of the factors contributing to organ failures and mortality in patients with COVID-19. Due to chronic inflammation, COVID-19 patients with diabetes mellitus (DM) or renal disease (RD) have more severe symptoms and higher mortality. However, the factors that contribute to severe outcomes of COVID-19 patients with DM and RD have received little attention. In an effort to investigate potential treatments for COVID-19, recent research has focused on the immunomodulation functions of mesenchymal stem cells (MSCs). In this study, the correlation between DM and RD and the severity of COVID-19 was examined by a combined approach with a meta-analysis and experimental research. The results of a systematic review and meta-analysis suggested that the odd of mortality in patients with both DM and RD was increased in comparison to those with a single comorbidity. In addition, in the experimental research, the data showed that high glucose and uremic toxins contributed to the induction of cytokine storm in human lung adenocarcinoma epithelial cells (Calu-3 cells) in response to SARS-CoV Peptide Pools. Of note, the incorporation of Wharton's jelly MSC-derived extracellular vesicles (WJ-EVs) into SARS-CoV peptide-induced Calu-3 resulted in a significant decrease in nuclear NF-κB p65 and the downregulation of the cytokine storm under high concentrations of glucose and uremic toxins. This clearly suggests the potential for WJ-EVs to reduce cytokine storm reactions in patients with both chronic inflammation diseases and viral infection.
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Affiliation(s)
- Vuong Cat Khanh
- Laboratory of Regenerative Medicine and Stem Cell Biology, Departments of University of Tsukuba, Tsukuba, Japan
| | - Mizuho Fukushige
- Laboratory of Regenerative Medicine and Stem Cell Biology, Departments of University of Tsukuba, Tsukuba, Japan
| | - Yun Hsuan Chang
- Laboratory of Regenerative Medicine and Stem Cell Biology, Departments of University of Tsukuba, Tsukuba, Japan
| | - Ngo Nhat Hoang
- Laboratory of Regenerative Medicine and Stem Cell Biology, Departments of University of Tsukuba, Tsukuba, Japan
| | - Toshiharu Yamashita
- Laboratory of Regenerative Medicine and Stem Cell Biology, Departments of University of Tsukuba, Tsukuba, Japan
| | | | - Hiromi Hamada
- Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan
| | - Motoo Osaka
- Cardiovascular Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yuji Hiramatsu
- Cardiovascular Surgery, University of Tsukuba, Tsukuba, Japan
| | - Osamu Ohneda
- Laboratory of Regenerative Medicine and Stem Cell Biology, Departments of University of Tsukuba, Tsukuba, Japan
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15
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Wu Q, Wu S, Cheng Y, Zhang Z, Mao G, Li S, Yang Y, Zhang X, Wu M, Tong H. Sargassum fusiforme fucoidan modifies gut microbiota and intestinal metabolites during alleviation of hyperglycemia in type 2 diabetic mice. Food Funct 2021; 12:3572-3585. [PMID: 33900346 DOI: 10.1039/d0fo03329d] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Type 2 diabetic mellitus (T2DM) is a complicated metabolic disorder that is now considered as a major global public health problem. Fucoidan exhibits diverse biological activities, especially prevention of metabolic diseases. In this regard, we herein aimed to reveal the beneficial effect of Sargassum fusiforme fucoidan (SFF) on high-fat diet (HFD) and streptozotocin (STZ) induced T2DM mice. We noted that on the one hand, SFF significantly decreased fasting blood glucose, diet and water intake, and hyperlipidemia, while on the other hand, it improved glucose tolerance. Furthermore, SFF reduced epididymal fat deposition, attenuated the pathological changes in heart and liver tissues, and decreased oxidative stress in diabetic mice. To explore the underlying mechanisms of these ameliorative effects, the gut microbiota was analyzed. Notably, SFF highly enriched benign microbes including Bacteroides, Faecalibacterium and Blautia, as well as increased levels of (R)-carnitine and choline in the colon of diabetic mice. This may be a potential mechanism for alleviating T2DM, thus implying the benefits of SFF as an adjuvant agent for T2DM treatment. Taken together, this study demonstrated a promising application of fucoidan as one of the adjuvant agents for the management of T2DM in the future.
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Affiliation(s)
- Qifang Wu
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Siya Wu
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Yang Cheng
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Zhongshan Zhang
- Key Laboratory of Vector Biology and Pathogen Control of Zhejiang Province, Huzhou University, Huzhou Cent Hosp, Huzhou 313000, China
| | - Genxiang Mao
- Zhejiang Provincial Key Lab of Geriatrics, Department of Geriatrics, Zhejiang Hospital, Hangzhou 310013, China
| | - Shijun Li
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Yue Yang
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Xu Zhang
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Mingjiang Wu
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
| | - Haibin Tong
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China.
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16
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Kanimozhi N, Singaravel G. Hybrid artificial fish particle swarm optimizer and kernel extreme learning machine for type-II diabetes predictive model. Med Biol Eng Comput 2021; 59:841-867. [PMID: 33738640 DOI: 10.1007/s11517-021-02333-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 02/03/2021] [Indexed: 10/21/2022]
Abstract
The World Health Organization (WHO) estimated that in 2016, 1.6 million deaths caused were due to diabetes. Precise and on-time diagnosis of type-II diabetes is crucial to reduce the risk of various diseases such as heart disease, stroke, kidney disease, diabetic retinopathy, diabetic neuropathy, and macrovascular problems. The non-invasive methods like machine learning are reliable and efficient in classifying the people subjected to type-II diabetics risk and healthy people into two different categories. This present study aims to develop a stacking-based integrated kernel extreme learning machine (KELM) model for identifying the risk of type-II diabetic patients based on the follow-up time on the diabetes research center dataset. The Pima Indian Diabetic Dataset (PIDD) and a Diabetic Research Center dataset are used in this study. A min-max normalization is used to preprocess the noisy datasets. The Hybrid Particle Swarm Optimization-Artificial Fish Swarm Optimization (HAFPSO) algorithm used satisfies the multi-objective problem by increasing the Classification Accuracy (CA) and decreasing the kernel complexity of the optimal learners (NBC) selected. At last, the model is integrated by utilizing the KELM as a meta-classifier which combines the predictions of the twenty Base Learners as a whole. The proposed classification method helps the clinicians to predict the patients who are at a high risk of type-II diabetes in the future with the highest accuracy of 98.5%. The proposed method is tested with different measures such as accuracy, sensitivity, specificity, Mathews Correlation Coefficient, and Kappa Statistics are calculated. The results obtained show that the KELM-HAFPSO approach is a promising new tool for identifying type-II diabetes.
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Affiliation(s)
- N Kanimozhi
- Department of Computer Science and Engineering, GKM College of Engineering and Technology, Chennai, India.
| | - G Singaravel
- Department of Information Technology, K S Rangasamy College of Engineering, Tiruchengode, India
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17
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Carvalho LSF, Benseñor IM, Nogueira ACC, Duncan BB, Schmidt MI, Blaha MJ, Toth PP, Jones SR, Santos RD, Lotufo PA, Sposito AC. Increased particle size of triacylglycerol-enriched remnant lipoproteins, but not their plasma concentration or lipid content, augments risk prediction of incident type 2 diabetes. Diabetologia 2021; 64:385-396. [PMID: 33159534 DOI: 10.1007/s00125-020-05322-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/21/2020] [Indexed: 12/11/2022]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes prevention requires the accurate identification of those at high risk. Beyond the association of fasting serum triacylglycerols with diabetes, triacylglycerol-enriched remnant lipoproteins (TRLs) more accurately reflect pathophysiological changes that underlie progression to diabetes, such as hepatic insulin resistance, pancreatic steatosis and systemic inflammation. We hypothesised that TRL-related factors could improve risk prediction for incident diabetes. METHODS We included individuals from the Brazilian Longitudinal Study of Adult Health cohort. We trained a logistic regression model for the risk of incident diabetes in 80% of the cohort using tenfold cross-validation, and tested the model in the remaining 20% of the cohort (test set). Variables included medical history and traits of the metabolic syndrome, followed by TRL-related measurements (plasma concentration, TRL particle diameter, cholesterol and triacylglycerol content). TRL features were measured using NMR spectroscopy. Discrimination was assessed using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). RESULTS Among 4463 at-risk individuals, there were 366 new cases of diabetes after a mean (±SD) of 3.7 (±0.63) years of follow-up. We derived an 18-variable model with a global AUROC of 0.846 (95% CI: 0.829, 0.869). Overall TRL-related markers were not associated with diabetes. However, TRL particle diameter increased the AUROC, particularly in individuals with HbA1c <39 mmol/mol (5.7%) (hold-out test set [n = 659]; training-validation set [n = 2638]), but not in individuals with baseline HbA1c 39-46 mmol/mol (5.7-6.4%) (hold-out test set [n = 233]; training-validation set [n = 933]). In the subgroup with baseline HbA1c <39 mmol/mol (5.7%), AUROC in the test set increased from 0.717 (95% CI 0.603, 0.818) to 0.794 (95% CI 0.731, 0.862), and AUPRC in the test set rose from 0.582 to 0.701 when using the baseline model and the baseline model plus TRL particle diameter, respectively. TRL particle diameter was highly correlated with obesity, insulin resistance and inflammation in those with impaired fasting glucose at baseline, but less so in those with HbA1c <39 mmol/mol (5.7%). CONCLUSIONS/INTERPRETATION TRL particle diameter improves the prediction of diabetes, but only in individuals with HbA1c <39 mmol/mol (5.7%) at baseline. These data support TRL particle diameter as a risk factor that is changed early in the course of the pathophysiological processes that lead to the development of type 2 diabetes, even before glucose abnormalities are established. Graphical abstract.
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Affiliation(s)
- Luiz Sérgio F Carvalho
- Data Lab, Clarity Healthcare Intelligence, Jundiaí, SP, Brazil.
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
- Laboratory of Data for Quality of Care and Outcomes Research, Institute for Strategic Management in Healthcare DF (IGESDF), Brasília, DF, Brazil.
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Ana C C Nogueira
- Laboratory of Data for Quality of Care and Outcomes Research, Institute for Strategic Management in Healthcare DF (IGESDF), Brasília, DF, Brazil
| | - Bruce B Duncan
- Postgraduate Studies Program in Epidemiology, School of Medicine and Hospital de Clínicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria I Schmidt
- Postgraduate Studies Program in Epidemiology, School of Medicine and Hospital de Clínicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Michael J Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Peter P Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
- Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| | - Steven R Jones
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Raul D Santos
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, SP, Brazil
- Lipid Clinic Heart Institute (InCor), University of São Paulo, Medical School Hospital, São Paulo, SP, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Andrei C Sposito
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil
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18
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Nyenwe E, James D, Wan J, Dagogo-Jack S. Glycemic Response to Oral Dexamethasone Predicts Incident Prediabetes in Normoglycemic Subjects With Parental Diabetes. J Endocr Soc 2020; 4:bvaa137. [PMID: 33134765 PMCID: PMC7585402 DOI: 10.1210/jendso/bvaa137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/16/2020] [Indexed: 12/22/2022] Open
Abstract
Background Prediabetes, an often unrecognized precursor of type 2 diabetes (T2DM), is associated with cardiometabolic complications. Here, we investigated the utility of dexamethasone challenge in predicting incident prediabetes among normoglycemic subjects with parental T2DM enrolled in the prospective Pathobiology of Prediabetes in a Biracial Cohort study. Design and Methods After documenting normoglycemic status with an oral glucose tolerance test (OGTT), participants ingested dexamethasone (2 mg) at 10:00 pm, and fasting plasma glucose (FPG-Dex) and cortisol were measured at 8:00 am the next day. Subjects were followed quarterly for 5 years, the primary outcome being incident prediabetes. Serial assessments included body composition, blood chemistry, OGTT, insulin sensitivity, and secretion. Results We analyzed data from 190 participants (107 Black, 83 white; mean age 44.7 ± 10.0 years; body mass index [BMI] 29.8 ± 6.8 kg/m2; fasting plasma glucose [FPG] 90.9 ± 5.7 mg/dL). Following dexamethasone ingestion, plasma cortisol was < 5 µg/dL; FPG-Dex levels displayed marked variability (81-145 mg/dL) as did delta FPG (–7 to +48 mg/dL). During 5 years of follow-up, 58 of 190 subjects (30.5%) progressed to prediabetes. FPG-Dex (116.8 ± 10.9 vs 106.9 ± 10.8 mg/dL, P < 0.0001) and delta FPG (23.4 ± 10.1 vs 17.0 ± 10.2 mg/dL, P < 0.0001) were higher in progressors than nonprogressors. FPG-Dex (P = 0.007) was an independent predictor of incident prediabetes in a multivariate model that included age, race, gender, BMI, waist circumference, FPG, insulin sensitivity, and secretion. In further analyses, an FPG-Dex level ≥ 107 mg/dL predicted incident prediabetes with 88% sensitivity and 49% specificity. Conclusions The glycemic response to dexamethasone significantly predicted incident prediabetes among offspring of parents with T2DM, and may be a tool for uncovering latent risk of dysglycemia.
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Affiliation(s)
- Ebenezer Nyenwe
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism
| | - Deirdre James
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism
| | - Jim Wan
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Sam Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism
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19
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La Sala L, Tagliabue E, de Candia P, Prattichizzo F, Ceriello A. One-hour plasma glucose combined with skin autofluorescence identifies subjects with pre-diabetes: the DIAPASON study. BMJ Open Diabetes Res Care 2020; 8:8/1/e001331. [PMID: 32928791 PMCID: PMC7488794 DOI: 10.1136/bmjdrc-2020-001331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/19/2020] [Accepted: 07/25/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The major challenge for diabetes prevention is early identification of individuals at risk to allow for implementation of measures to delay the onset of future disease. Measures such as fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c) are equally appropriate for identifying pre-diabetes and diabetes, but do not all identify the disease in the same individual. We tested the utility of a diagnostic method combining FPG, 2hPG and HbA1c for early evaluation and easy identification of pre-diabetes. RESEARCH DESIGN AND METHODS 531 subjects underwent skin autofluorescence (SAF) and glycemia analyses. We created two classification groups based on the American Diabetes Association diagnosis guidelines: (1) based on 2hPG and (2) based on a new combination of three glycemia parameters (the three-criteria strategy (3-c)). Logistic regression modeling was used to estimate the associations. RESULTS SAF showed high associations for both 3-c definition and 2hPG definition alone. These associations appeared stronger in 3-c than those in 2hPG. The non-invasive SAF measurement outperformed 2hPG in the detection of dysglycemia or pre-diabetes. Stepwise selections identified 1-hour postload glucose (1hPG) as variable identifying pre-diabetes using the 2hPG criterion, and the model based on 1hPG plus SAF appeared to be the best association using the 3-c strategy. CONCLUSIONS 1hPG coupled with SAF showed a strong association in the evaluation of pre-diabetes using the 3-c method.
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Affiliation(s)
- Lucia La Sala
- Department of Crdiovascular and Metabolic Disease, IRCCS MultiMedica, Milan, Italy
| | - Elena Tagliabue
- Department of Crdiovascular and Metabolic Disease, IRCCS MultiMedica, Milan, Italy
| | - Paola de Candia
- Department of Crdiovascular and Metabolic Disease, IRCCS MultiMedica, Milan, Italy
| | | | - Antonio Ceriello
- Department of Crdiovascular and Metabolic Disease, IRCCS MultiMedica, Milan, Italy
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Daily mycoprotein consumption for 1 week does not affect insulin sensitivity or glycaemic control but modulates the plasma lipidome in healthy adults: a randomised controlled trial. Br J Nutr 2020; 125:147-160. [DOI: 10.1017/s0007114520002524] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractMycoprotein consumption has been shown to improve acute postprandial glycaemic control and decrease circulating cholesterol concentrations. We investigated the impact of incorporating mycoprotein into the diet on insulin sensitivity (IS), glycaemic control and plasma lipoprotein composition. Twenty healthy adults participated in a randomised, parallel-group trial in which they consumed a 7 d fully controlled diet where lunch and dinner contained either meat/fish (control group, CON) or mycoprotein (MYC) as the primary source of dietary protein. Oral glucose tolerance tests were performed pre- and post-intervention, and 24 h continuous blood glucose monitoring was applied throughout. Fasting plasma samples were obtained pre- and post-intervention and were analysed using quantitative, targeted NMR-based metabonomics. There were no changes within or between groups in blood glucose or serum insulin responses, nor in IS or 24 h glycaemic profiles. No differences between groups were found for 171 of the 224 metabonomic targets. Forty-five lipid concentrations of different lipoprotein fractions (VLDL, LDL, intermediate-density lipoprotein and HDL) remained unchanged in CON but showed a coordinated decrease (7–27 %; all P < 0·05) in MYC. Total plasma cholesterol, free cholesterol, LDL-cholesterol, HDL2-cholesterol, DHA and n-3 fatty acids decreased to a larger degree in MYC (14–19 %) compared with CON (3–11 %; P < 0·05). Substituting meat/fish for mycoprotein twice daily for 1 week did not modulate whole-body IS or glycaemic control but resulted in changes to plasma lipid composition, the latter primarily consisting of a coordinated reduction in circulating cholesterol-containing lipoproteins.
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Hirakawa Y, Hata J, Yoshinari M, Higashioka M, Yoshida D, Shibata M, Honda T, Sakata S, Kato H, Teramoto T, Maki H, Nishimoto S, Kitazono T, Ninomiya T. 30-minute postload plasma glucose levels during an oral glucose tolerance test predict the risk of future type 2 diabetes: the Hisayama Study. BMJ Open Diabetes Res Care 2020; 8:8/1/e001156. [PMID: 32675171 PMCID: PMC7368480 DOI: 10.1136/bmjdrc-2019-001156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 03/21/2020] [Accepted: 05/18/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION To investigate the associations of 30 min postload plasma glucose (30 mPG) levels during an oral glucose tolerance test (OGTT) with the risk of future diabetes in a general Japanese population. RESEARCH DESIGN AND METHODS A total of 2957 Japanese community-dwelling residents without diabetes, aged 40-79 years, participated in the examinations in 2007 and 2008 (participation rate, 77.1%). Among them, 2162 subjects who received 75 g OGTT in a fasting state with measurements of plasma glucose level at 0, 30, and 120 min were followed up for 7 years (2007-2014). Cox's proportional hazards model was used to estimate HRs and their 95% CIs of each index for the development of type 2 diabetes using continuous variables and quartiles with adjustment for traditional risk factors. The influence of 30 mPG on the predictive ability was estimated with Harrell's C-statistics, integrated discrimination improvement (IDI), and the continuous net reclassification index (cNRI). RESULTS During follow-up, 275 subjects experienced type 2 diabetes. Elevated 30 mPG levels were significantly associated with increased risk of developing diabetes (p<0.01 for trend): the multivariable-adjusted HR was 8.41 (95% CI 4.97 to 14.24) for the highest versus the lowest quartile, and 2.26 (2.04 to 2.52) per 1 SD increase. This association was attenuated but remained significant after further adjustment for fasting and 2-hour postload plasma glucose levels. Incorporation of 30 mPG into the model including traditional risk factors with fasting and 2-hour postload plasma glucose levels for diabetes improved the predictive ability of type 2 diabetes (improvement in Harrell's C-statistics values: from 0.828 to 0.839, p<0.01; IDI: 0.016, p<0.01; cNRI: 0.103, p=0.37). CONCLUSIONS Elevated 30 mPG levels were associated with increased risk of diabetes, and inclusion of 30 mPG levels significantly improved the predictive ability for future diabetes, suggesting that 30 mPG may be useful for identifying high-risk populations for type 2 diabetes.
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Grants
- Health and Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan (H29-Junkankitou-Ippan-003 and H30-Shokuhin-[Sitei]-005)
- Grants-in-Aid for Scientific Research (A) (JP16H02692),(B) (JP16H05850, JP17H04126, and JP18H02737),and (C) (JP17K09114, JP17K09113, JP17K01853, JP18K07565, JP18K09412, and JP19K07890) and for Early-Career Scientists (JP18K17925 and JP18K17382) from the Ministry of Education, Culture, Sports, Science and Technology of Japan
- Suntory Beverage & Food Limited (Tokyo, Japan)
- the Japan Agency for Medical Research and Development (JP19dk0207025, JP19ek0210082, JP19ek0210083, JP19km0405202, JP19ek0210080, and JP19fk0108075)
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Affiliation(s)
- Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahito Yoshinari
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mayu Higashioka
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoko Sakata
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Kato
- Development & Design Department, Japan Business Division, Suntory Beverage & Food Limited, Kanagawa, Japan
| | - Takanori Teramoto
- Development & Design Department, Japan Business Division, Suntory Beverage & Food Limited, Kanagawa, Japan
| | - Hideki Maki
- Development & Design Department, Japan Business Division, Suntory Beverage & Food Limited, Kanagawa, Japan
| | - Shozo Nishimoto
- Development & Design Department, Japan Business Division, Suntory Beverage & Food Limited, Kanagawa, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Abstract
Obesity and type 2 diabetes are the most frequent metabolic disorders, but their causes remain largely unclear. Insulin resistance, the common underlying abnormality, results from imbalance between energy intake and expenditure favouring nutrient-storage pathways, which evolved to maximize energy utilization and preserve adequate substrate supply to the brain. Initially, dysfunction of white adipose tissue and circulating metabolites modulate tissue communication and insulin signalling. However, when the energy imbalance is chronic, mechanisms such as inflammatory pathways accelerate these abnormalities. Here we summarize recent studies providing insights into insulin resistance and increased hepatic gluconeogenesis associated with obesity and type 2 diabetes, focusing on data from humans and relevant animal models.
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Iskandar S, Migahid A, Kamal D, Megahed O, DeFronzo RA, Zirie M, Jayyousi A, Al Jaidah M, Abdul-Ghani M. Glycated hemoglobin versus oral glucose tolerance test in the identification of subjects with prediabetes in Qatari population. BMC Endocr Disord 2019; 19:87. [PMID: 31438915 PMCID: PMC6704621 DOI: 10.1186/s12902-019-0412-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 07/19/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Subjects with prediabetes are at increased risk of future T2DM and cardiovascular disease (CVD) compared to NGT individuals. The OGTT (FPG = 100-125 and 2 h-PG = 140-199 mg/dl) and HbA1c 5.7-6.4% have been used to diagnose subjects with prediabetes. In the present study, we compared the ability of the OGTT and HbA1c to identify Qatari subjects with prediabetes. METHODS Four hundred forty six subjects without a history of T2DM received 75-g OGTT and measurement of HbA1c. The incidence of prediabetes in this cohort according to OGTT criteria was compared to that of HbA1c criteria. RESULTS The agreement between the OGTT and HbA1c in identifying subjects with prediabetes in Qatari subjects was poor, though significant (k = 015, p < 0.0001). Only 56% of participants had prediabetes or NGT according to OGTT and HbA1c. The disagreement between OGTT and HbA1c in diagnosing prediabetes was primarily due to low sensitivity of HbA1c. Moreover, subjects with prediabetes diagnosed with the OGTT have more severe metabolic profile than prediabetic subjects diagnosed with HbA1c. Lastly, more subjects with the metabolic syndrome were identified with OGTT (60%) criteria than with the HbA1c (49%), p < 0.0001. CONCLUSION These results demonstrate subjects with prediabetes diagnosed with OGTT have more severe metabolic risk than those diagnosed with HbA1c, and more likely to have greater risk of progression to T2DM.
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Affiliation(s)
| | - Ayman Migahid
- Academic Health System, Hamad General Hospital, PO Box 3050, Doha, Qatar
| | - Dalia Kamal
- Academic Health System, Hamad General Hospital, PO Box 3050, Doha, Qatar
| | - Osama Megahed
- Academic Health System, Hamad General Hospital, PO Box 3050, Doha, Qatar
| | - Ralph A. DeFronzo
- Diabetes Division, University of Texas Health Science Center, San Antonio, TX USA
| | - Mahmoud Zirie
- Academic Health System, Hamad General Hospital, PO Box 3050, Doha, Qatar
| | - Amin Jayyousi
- Academic Health System, Hamad General Hospital, PO Box 3050, Doha, Qatar
| | | | - Muhammad Abdul-Ghani
- Academic Health System, Hamad General Hospital, PO Box 3050, Doha, Qatar
- Diabetes Division, University of Texas Health Science Center, San Antonio, TX USA
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Lee KW, Woo HD, Cho MJ, Park JK, Kim SS. Identification of Dietary Patterns Associated with Incidence of Hyperglycemia in Middle-Aged and Older Korean Adults. Nutrients 2019; 11:nu11081801. [PMID: 31382699 PMCID: PMC6723075 DOI: 10.3390/nu11081801] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 12/18/2022] Open
Abstract
Little is known about the association between dietary patterns and hyperglycemia incidence among Korean adults. Hence, we aimed to prospectively investigate the major dietary patterns associated with hyperglycemia among middle-aged and older Korean adults. In total, 55,457 adults (18,292 men and 37,165 women) aged 40 to 79 years, who were previously enrolled in the Health Examinee Study of the Korean Genome and Epidemiology Study and had no history of type 2 diabetes mellitus (T2DM) or cancer at baseline, were included. Dietary patterns were identified by a factor analysis based on dietary data, which were assessed at baseline using a validated food-frequency questionnaire. Participants were classified as having hyperglycemia if fasting blood glucose levels were ≥126 mg/dL or physician diagnosed T2DM during follow-up. Multivariable Cox proportional hazard models were used to examine the associations between each dietary pattern and future hyperglycemia risk after adjusting for potential confounders. After a mean follow-up of 4.9 years, 2574 new cases of hyperglycemia were identified. Using a factor analysis, four distinct dietary patterns were identified: “prudent;” “fatty fish, meat, and flour-based food;” “coffee and sweets;” and “whole grain (men)” or “white rice (women).” The “prudent” pattern was inversely associated with hyperglycemia risk only in women (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.63–0.89; p for trend = 0.0003). Conversely, women in the highest quintile of the “fatty fish, meat, and flour-based food” pattern showed an increased risk of hyperglycemia (HR, 1.22; 95% CI, 1.03–1.44; p for trend = 0.0210) compared with those in the lowest quintile. The “coffee and sweets” and “white rice” patterns were not associated with hyperglycemia risk in women. The dietary patterns observed in men had no associations with hyperglycemia incidence. Our findings suggest that a diet rich in vegetables, mushrooms, seaweeds, fruits, and soy products and low in fatty fish and high-fat meat may potentially play a protective role in T2DM development with sex differences in middle-aged and older Korean adults.
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Affiliation(s)
- Kyung Won Lee
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do 28160, Korea
| | - Hae Dong Woo
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do 28160, Korea
| | - Mi Jin Cho
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do 28160, Korea
| | - Jae Kyung Park
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do 28160, Korea
| | - Sung Soo Kim
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do 28160, Korea.
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Abbasi F, Tern PJ, Reaven GM. Plasma glucose concentration 60 min post oral glucose load and risk of type 2 diabetes and cardiovascular disease: Pathophysiological implications. Diab Vasc Dis Res 2019; 16:337-343. [PMID: 30755013 DOI: 10.1177/1479164119827239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM The aim of this study was to gain insight into the pathophysiological significance of elevated plasma glucose concentrations (mmol/L) 60 min post oral glucose load in apparently healthy individuals. METHODS Comparison of resistance to insulin action and associated cardio-metabolic risk factors in 490 apparently healthy persons, subdivided into those with a plasma glucose concentration 60 min following a 75-g oral glucose challenge of <8.6 versus ⩾8.6. RESULTS Insulin resistance was significantly greater in persons with normal glucose tolerance whose 60-min glucose concentration was ⩾8.6, associated with higher blood pressure, plasma concentrations of glucose, insulin, triglyceride and lower high-density lipoprotein cholesterol concentrations. Similar differences were seen in persons with impaired fasting glucose, but not in those with impaired glucose tolerance or both impaired fasting glucose and impaired glucose tolerance. The group whose 60-min glucose was <8.6 (n = 318) contained primarily persons with normal glucose tolerance (88%), whereas the majority of those whose 60-min value was ⩾8.6 (n = 172) had prediabetes (59%) and in particular combined impaired fasting glucose and impaired glucose tolerance. CONCLUSION Plasma glucose concentration of ⩾8.6 mmol/L 60 min post oral glucose identifies higher proportions of combined impaired fasting glucose and impaired glucose tolerance individuals as well as normal glucose tolerance and impaired fasting glucose individuals with a more adverse cardio-metabolic profile, contributing to observed increased overall risk of type 2 diabetes and other metabolic diseases.
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Affiliation(s)
- Fahim Abbasi
- 1 Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Paul Jw Tern
- 2 University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Gerald M Reaven
- 1 Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Farran B, AlWotayan R, Alkandari H, Al-Abdulrazzaq D, Channanath A, Thanaraj TA. Use of Non-invasive Parameters and Machine-Learning Algorithms for Predicting Future Risk of Type 2 Diabetes: A Retrospective Cohort Study of Health Data From Kuwait. Front Endocrinol (Lausanne) 2019; 10:624. [PMID: 31572303 PMCID: PMC6749017 DOI: 10.3389/fendo.2019.00624] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 08/28/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: In recent decades, the Arab population has experienced an increase in the prevalence of type 2 diabetes (T2DM), particularly within the Gulf Cooperation Council. In this context, early intervention programmes rely on an ability to identify individuals at risk of T2DM. We aimed to build prognostic models for the risk of T2DM in the Arab population using machine-learning algorithms vs. conventional logistic regression (LR) and simple non-invasive clinical markers over three different time scales (3, 5, and 7 years from the baseline). Design: This retrospective cohort study used three models based on LR, k-nearest neighbours (k-NN), and support vector machines (SVM) with five-fold cross-validation. The models included the following baseline non-invasive parameters: age, sex, body mass index (BMI), pre-existing hypertension, family history of hypertension, and T2DM. Setting: This study was based on data from the Kuwait Health Network (KHN), which integrated primary health and hospital laboratory data into a single system. Participants: The study included 1,837 native Kuwaiti Arab individuals (equal proportion of men and women) with mean age as 59.5 ± 11.4 years. Among them, 647 developed T2DM within 7 years of the baseline non-invasive measurements. Analytical methods: The discriminatory power of each model for classifying people at risk of T2DM within 3, 5, or 7 years and the area under the receiver operating characteristic curve (AUC) were determined. Outcome measures: Onset of T2DM at 3, 5, and 7 years. Results: The k-NN machine-learning technique, which yielded AUC values of 0.83, 0.82, and 0.79 for 3-, 5-, and 7-year prediction horizons, respectively, outperformed the most commonly used LR method and other previously reported methods. Comparable results were achieved using the SVM and LR models with corresponding AUC values of (SVM: 0.73, LR: 0.74), (SVM: 0.68, LR: 0.72), and (SVM: 0.71, LR: 0.70) for 3-, 5-, and 7-year prediction horizons, respectively. For all models, the discriminatory power decreased as the prediction horizon increased from 3 to 7 years. Conclusions: Machine-learning techniques represent a useful addition to the commonly reported LR technique. Our prognostic models for the future risk of T2DM could be used to plan and implement early prevention programmes for at risk groups in the Arab population.
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Affiliation(s)
- Bassam Farran
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Rihab AlWotayan
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Primary Health Care, Ministry of Health, Kuwait City, Kuwait
| | - Hessa Alkandari
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Farwaniya Hospital, Al Farwaniyah, Kuwait
| | - Dalia Al-Abdulrazzaq
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Thangavel Alphonse Thanaraj
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- *Correspondence: Thangavel Alphonse Thanaraj
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Tsuboi A, Minato S, Yano M, Takeuchi M, Kitaoka K, Kurata M, Yoshino G, Wu B, Kazumi T, Fukuo K. Higher circulating adiponectin and lower orosomucoid were associated with postload glucose ≤70 mg/dL, a possible inverse marker for dysglycemia, in young Japanese women. BMJ Open Diabetes Res Care 2019; 7:e000596. [PMID: 30899529 PMCID: PMC6398809 DOI: 10.1136/bmjdrc-2018-000596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/16/2018] [Accepted: 12/28/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To examine whether serum adiponectin and orosomucoid were associated with postload glucose ≤70 mg/dL during an oral glucose tolerance test (OGTT), termed as postload low glycemia, a possible inverse marker for dysglycemia. RESEARCH DESIGN AND METHODS 75 g OGTTs were performed with multiple postload glucose and insulin measurements over a 30-120 min period in 168 normal-weight Japanese women (18-24 years). Insulin resistance (IR) and β-cell function inferred from serum insulin kinetics during OGTT, fat mass and distribution by dual-energy X-ray absorptiometry (DXA), serum adiponectin and inflammatory markers were compared cross-sectionally between 39 women with and 129 women without postload low glycemia. RESULTS Of 168 women, 161 had normal glucose tolerance. Women with as compared with those without postload low glycemia had lower fasting and postload glycemia despite similar fasting and postload insulinemia. They had higher insulinogenic index (p=0.03) and lower adipose IR (a product of fasting free fatty acid and insulin, p=0.01), although DXA-derived general and central adiposity, the Matsuda Index and homeostasis model assessment-IR did not differ. In addition, they had higher adiponectin and lower orosomucoid (both p<0.001). Multivariate logistic regression analyses revealed that adiponectin (OR: 1.14, 95% CI 1.03 to 1.26, p=0.009) and orosomucoid (0.96, 0.93 to 0.97, p=0.008) were associated with postload low glycemia independently of adipose IR and insulinogenic index. CONCLUSIONS Higher adiponectin and lower orosomucoid were associated with 70 or lower mg/dL of postload glucose, a possible inverse marker for dysglycemia, in young women independently of DXA-derived fat mass and distribution, insulin secretion and IR.
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Affiliation(s)
- Ayaka Tsuboi
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Satomi Minato
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
- Graduate School of Human Science and Environment, University of Hyogo, Himeji, Hyogo, Japan
| | - Megumu Yano
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
| | - Mika Takeuchi
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
- Department of Nutritional Sciences for Well-Being, Faculty of Health Sciences for Welfare, Kansai University of Welfare Sciences, Kashiwara, Osaka, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
| | - Gen Yoshino
- Diabetes Center, Shinsuma Hospital, Kobe, Hyogo, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University Diabetes Division, Nishinomiya, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
- Department of Medicine, Kohnan Kakogawa Hospital, Kakogawa, Hyogo, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
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Temple KA, Leproult R, Morselli L, Ehrmann DA, Van Cauter E, Mokhlesi B. Sex Differences in the Impact of Obstructive Sleep Apnea on Glucose Metabolism. Front Endocrinol (Lausanne) 2018; 9:376. [PMID: 30042734 PMCID: PMC6048262 DOI: 10.3389/fendo.2018.00376] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/22/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives: Obstructive sleep apnea (OSA) is more prevalent in men and is an independent risk factor for type 2 diabetes. We aimed to determine if there are sex differences in the impact of OSA on glucose metabolism in nondiabetic overweight and obese adults. Methods: One hundred and forty-five men and women (age 33.4 ± 0.6, BMI 37.2 ± 0.7, 70.3% blacks) from the community underwent in-laboratory polysomnography. Severity of OSA was assessed by the apnea-hypopnea index (AHI). Glucose tolerance was assessed using fasting glucose, 1-h glucose, 2-h glucose and the area under the curve (AUC) during the 2-h oral glucose tolerance test (OGTT). Fasting insulin resistance was assessed by HOMA-IR, and insulin sensitivity during the OGTT was assessed by the Matsuda Index. Pancreatic beta-cell function was assessed by fasting HOMA-%B and by AUCinsulin/glucose, insulinogenic index, and oral disposition index (DIoral) during the OGTT. All comparisons were adjusted for age, BMI, race and severity of OSA. Results: There were no significant demographic differences between men and women without OSA. Men and women with OSA were similar in age, BMI, and severity of OSA, but there were more black women with OSA. Compared to women with OSA, men with OSA had significantly higher fasting glucose, 1-h glucose levels, AUCglucose, and AUC for insulin secretion rate (AUCISR) but similar 2-h glucose levels. These differences persisted in adjusted analyses. Men with OSA secreted significantly more insulin than women with OSA in order to achieve similar glucose levels. Men with OSA had significantly worse beta cell function as measured by the DIoral than women with OSA. In contrast, there were no significant sex differences in measures of glucose tolerance and beta-cell function in participants without OSA. Conclusion: Men with OSA secreted more insulin compared to women with OSA in order to maintain glucose homeostasis. The adverse impact of OSA on beta-cell responsiveness was larger in men, which may result in an overall greater risk of type 2 diabetes compared to women.
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Affiliation(s)
- Karla A. Temple
- Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL, United States
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Rachel Leproult
- Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL, United States
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Lisa Morselli
- Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL, United States
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - David A. Ehrmann
- Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL, United States
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Eve Van Cauter
- Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL, United States
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Babak Mokhlesi
- Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL, United States
- Section of Pulmonary and Critical Care, Department of Medicine, Sleep Disorders Center, University of Chicago, Chicago, IL, United States
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Bergman M, Jagannathan R, Buysschaert M, Pareek M, Olsen MH, Nilsson PM, Medina JL, Roth J, Chetrit A, Groop L, Dankner R. Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised. Diabetes Metab Res Rev 2018; 34:e2992. [PMID: 29460410 DOI: 10.1002/dmrr.2992] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/14/2018] [Accepted: 02/02/2018] [Indexed: 02/06/2023]
Abstract
This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA1c or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.
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Affiliation(s)
- Michael Bergman
- Division of Endocrinology and Metabolism, Department of Medicine and of Population Health, School of Medicine, NYU Langone Diabetes Prevention Program, New York, NY, USA
| | - Ram Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | - Manan Pareek
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Michael H Olsen
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Peter M Nilsson
- Department of Clinical Sciences and Lund University Diabetes Centre, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Leif Groop
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Rachel Dankner
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Płaczkowska S, Kokot I, Pawlik-Sobecka L, Piwowar A. Assessment of HOMA1-IR, Matsuda and ISSI-2 indices in relation to the metabolic syndrome features and oral glucose tolerance test in young people. ACTA ACUST UNITED AC 2017. [DOI: 10.5604/01.3001.0013.7973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<I>Background:</I> Insulin resistance and reduced ability of pancreatic beta cells to secrete insulin preside carbohydrate disorders development and this condition is one of the stages in the type 2 diabetes development. Indirect indices of insulin resistance, sensitivity and pancreatic beta cells function, are used in clinical practice. They are calculated based on glucose and insulin concentration under fasting and postprandial condition.
<I>Aim:</I> The aim of this study was to examine relationship between HOMA1-IR, Matsuda Index, and ISSI-2 with metabolic syndrome (MS) features and shape of glycemic curve in young, potentially healthy people.
<i>Material and method:</i> The study group consisted of 152 volunteers (108 women, 44 men) aged 19-28. Participants underwent the questionnaire, anthropometric and arterial blood pressure examination. In blood samples under fasting condition lipid profiles, glucose, and insulin were measured. Glucose and insulin were measured also in 60 and 120 minutes of Oral Glucose Tolerance Test (OGTT). Based on the results, MS features were identified and HOMA1-IR, Matsuda Index and ISSI-2 values were calculated.
<I>Results:</I> The value of HOMA1-IR was significant higher in patients with metabolic syndrome while lower values of Matsuda and ISSI-2 were observed in participants with the MS as well as with glucose concentration in 120-minute of OGTT higher than under fasting condition.
<i> Conclusions:</i> MS is associated with an increase in hepatic insulin resistance. Both MS and retardation of glucose returning to fasting values during OGTT are related to peripheral insulin resistance and reduction of pancreatic beta cell ability to insulin secretion.
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Affiliation(s)
- Sylwia Płaczkowska
- Diagnostyczne Laboratorium Naukowo-Dydaktyczne, Wydział Farmaceutyczny z Oddziałem Analityki Medycznej, Uniwersytet Medyczny we Wrocławiu
| | - Izabela Kokot
- Zakład Praktycznej Nauki Zawodu Analityka, Wydział Farmaceutyczny z Oddziałem Analityki Medycznej, Uniwersytet Medyczny we Wrocławiu
| | - Lilla Pawlik-Sobecka
- Zakład Praktycznej Nauki Zawodu Analityka, Wydział Farmaceutyczny z Oddziałem Analityki Medycznej, Uniwersytet Medyczny we Wrocławiu
| | - Agnieszka Piwowar
- Katedra i Zakład Toksykologii, Wydział Farmaceutyczny z Oddziałem Analityki Medycznej, Uniwersytet Medyczny we Wrocławiu
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Jagannathan R, Bergman M. Use of 1-h post-load plasma glucose concentration to identify individuals at high risk of developing Type 2 diabetes. Diabet Med 2017; 34:877-878. [PMID: 28453866 DOI: 10.1111/dme.13370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 12/01/2022]
Affiliation(s)
- R Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - M Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, USA
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LIMA LUÍSM. Subclinical Diabetes. ACTA ACUST UNITED AC 2017; 89:591-614. [DOI: 10.1590/0001-3765201720160394] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 09/20/2016] [Indexed: 12/15/2022]
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Takeda Y, Fujita Y, Yanagimachi T, Honjo J, Abiko A, Asai M, Haneda M. Prediabetes Exhibits Decreased Disposition Index Correlated with Deterioration of Glycemic Parameters in Nonobese Japanese Subjects: A Cross-Sectional Study from Medical Examination. Metab Syndr Relat Disord 2017; 15:296-303. [PMID: 28436739 DOI: 10.1089/met.2016.0137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Prediabetes, defined as impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), likely develops to type 2 diabetes mellitus (DM) and independently increases cardiovascular risk. We employed disposition index (DI), a new metabolic parameter indicating the pancreatic beta cell function adjusted for insulin resistance, and investigated whether it could be altered in Japanese population with prediabetes and associated with early glucose intolerance. METHODS A total of 102 adults who underwent an oral glucose tolerance test at the medical screening were designated to normal glucose tolerance (NGT), IFG, IGT, and DM. We calculated insulinogenic index (IGI) and homeostasis model assessment (HOMA) of β cell function (HOMA-β) as insulin secretory function, HOMA-insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as insulin resistance and DI, and assessed correlations between these indices and glycemic parameters. RESULTS We observed graded increase of glycemic parameters in the order of NGT, IFG, IGT, and DM. HOMA-IR was significantly higher only in DM compared with NGT, although HOMA-β, IGI, and QUICKI showed no significant differences among the groups. In contrast, DI was significantly lower in IFG, IGT, and DM compared with NGT. In correlation analysis, glycemic parameters related positively to HOMA-IR, but inversely to DI. Only two parameters, IGI and particularly DI, were significantly decreased in the subjects with 1-hr postload glucose >8.6 mmol/L previously proposed as a predictor of type 2 diabetes. CONCLUSIONS Our results suggest that reduction of DI promptly reflects the alteration of early glucose intolerance in Japanese population presenting with prediabetes.
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Affiliation(s)
- Yasutaka Takeda
- 1 Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University , Asahikawa, Japan
| | - Yukihiro Fujita
- 1 Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University , Asahikawa, Japan
| | - Tsuyoshi Yanagimachi
- 1 Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University , Asahikawa, Japan
| | - Jun Honjo
- 1 Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University , Asahikawa, Japan
| | - Atsuko Abiko
- 1 Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University , Asahikawa, Japan
| | - Mahito Asai
- 2 Department of Diabetes and Metabolic Diseases, Nayoro City General Hospital , Nayoro, Japan
| | - Masakazu Haneda
- 1 Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University , Asahikawa, Japan
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Buysschaert M, Bergman M, Yanogo D, Jagannathan R, Buysschaert B, Preumont V. An elevated 1-h post- load glucose level during the oral glucose tolerance test detects prediabetes. Diabetes Metab Syndr 2017; 11:137-139. [PMID: 27986405 DOI: 10.1016/j.dsx.2016.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
AIM The objective of the study was to compare the diagnosis of dysglycemic states by conventional oral glucose tolerance test (OGTT) criteria (fasting and 2-h plasma glucose) with the 1-h post-load plasma glucose level. MATERIAL AND METHODS 34 individuals (mean age: 55±13years; BMI: 27.7±6.3kg/m2) at risk for prediabetes were administered a 75g OGTT. Individuals with normal glucose tolerance (NGT) or prediabetes were identified according to fasting and/or 2-h plasma glucose (PG) concentrations. Subsequently, subjects were divided in 2 groups: group 1 (n=21) with a 1-h PG<155mg/dl and group 2 (n=13) with a 1-h PG≥155mg/dl. HOMA was performed to assess β-cell function and insulin sensitivity. RESULTS NGT or prediabetes based on conventional criteria correlated with the 1-h PG<or≥155mg/dl (p<0.001). Moreover, the 1-h PG≥155mg/dl was associated with higher HbA1c levels (6.1±0.5 vs. 5.5±0.3%, p<0.001) and significantly impaired insulin secretion and hyperbolic product (BxS) on HOMA test vs. 1-h PG<155mg/dl. CONCLUSION The 1-h post-load plasma glucose value ≥155mg/dl is strongly associated with conventional criteria for (pre)diabetes and alterations of β-cell function.
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Affiliation(s)
- Martin Buysschaert
- Cliniques Universitaires Saint-Luc, Service d'Endocrinologie et Nutrition, B-1200 Bruxelles, Belgium.
| | - Michael Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, 530 First Avenue, Schwartz East, New-York, NY10.016, USA
| | - Donald Yanogo
- Hôpital National Blaise Compaoré, Ouagadougou, Burkina Faso
| | - Ram Jagannathan
- NYU School of Medicine, Department of Population Health Center for Healthful Behavior Change, New York, NY 10016, USA
| | - Benoit Buysschaert
- Cliniques Universitaires Saint-Luc, Service d'Endocrinologie et Nutrition, B-1200 Bruxelles, Belgium
| | - Vanessa Preumont
- Cliniques Universitaires Saint-Luc, Service d'Endocrinologie et Nutrition, B-1200 Bruxelles, Belgium
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35
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Bergman M, Jagannathan R, Buysschaert M, Medina JL, Sevick MA, Katz K, Dorcely B, Roth J, Chetrit A, Dankner R. Reducing the prevalence of dysglycemia: is the time ripe to test the effectiveness of intervention in high-risk individuals with elevated 1 h post-load glucose levels? Endocrine 2017; 55:697-701. [PMID: 28124259 DOI: 10.1007/s12020-017-1236-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/17/2017] [Indexed: 02/07/2023]
Abstract
Identifying the earliest time point on the prediabetic continuum is critical to avoid progressive deterioration in β-cell function. Progressively rising glucose levels even within the "normal range" occur considerably late in the evolution to diabetes thus presenting an important opportunity for earlier diagnosis, treatment, and possible reversal. An elevated 1 h postprandial glucose level, not detected by current diagnostic standards, may provide an opportunity for the early identification of those at risk. When the 1 h post-load glucose level is elevated, lifestyle intervention may have the greatest benefit for preserving β-cell function and prevent further progression to prediabetes and diabetes. In view of the considerable consistent epidemiologic data in large disparate populations supporting the predictive capacity of the1 h post-load value for predicting progression to diabetes and mortality, the time is therefore ripe to evaluate this hypothesis in a large, prospective multicenter randomized trial with lifestyle intervention.
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Affiliation(s)
- Michael Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA.
| | - Ram Jagannathan
- NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY, 10016, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | | | - Mary Ann Sevick
- NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY, 10016, USA
| | - Karin Katz
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA
| | - Brenda Dorcely
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA
| | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, North Shore, New York, 11030, USA
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Rachel Dankner
- The Feinstein Institute for Medical Research, Manhasset, North Shore, New York, 11030, USA
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
- Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
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Boortz KA, Syring KE, Lee RA, Dai C, Oeser JK, McGuinness OP, Wang JC, O'Brien RM. G6PC2 Modulates the Effects of Dexamethasone on Fasting Blood Glucose and Glucose Tolerance. Endocrinology 2016; 157:4133-4145. [PMID: 27653037 PMCID: PMC5086534 DOI: 10.1210/en.2016-1678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The glucose-6-phosphatase catalytic subunit 2 (G6PC2) gene encodes an islet-specific glucose-6-phosphatase catalytic subunit. G6PC2 forms a substrate cycle with glucokinase that determines the glucose sensitivity of insulin secretion. Consequently, deletion of G6pc2 lowers fasting blood glucose (FBG) without affecting fasting plasma insulin. Although chronic elevation of FBG is detrimental to health, glucocorticoids induce G6PC2 expression, suggesting that G6PC2 evolved to transiently modulate FBG under conditions of glucocorticoid-related stress. We show, using competition and mutagenesis experiments, that the synthetic glucocorticoid dexamethasone (Dex) induces G6PC2 promoter activity through a mechanism involving displacement of the islet-enriched transcription factor MafA by the glucocorticoid receptor. The induction of G6PC2 promoter activity by Dex is modulated by a single nucleotide polymorphism, previously linked to altered FBG in humans, that affects FOXA2 binding. A 5-day repeated injection paradigm was used to examine the chronic effect of Dex on FBG and glucose tolerance in wild-type (WT) and G6pc2 knockout mice. Acute Dex treatment only induces G6pc2 expression in 129SvEv but not C57BL/6J mice, but this chronic treatment induced G6pc2 expression in both. In 6-hour fasted C57BL/6J WT mice, Dex treatment lowered FBG and improved glucose tolerance, with G6pc2 deletion exacerbating the decrease in FBG and enhancing the improvement in glucose tolerance. In contrast, in 24-hour fasted C57BL/6J WT mice, Dex treatment raised FBG but still improved glucose tolerance, with G6pc2 deletion limiting the increase in FBG and enhancing the improvement in glucose tolerance. These observations demonstrate that G6pc2 modulates the complex effects of Dex on both FBG and glucose tolerance.
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Affiliation(s)
- Kayla A Boortz
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - Kristen E Syring
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - Rebecca A Lee
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - Chunhua Dai
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - James K Oeser
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - Owen P McGuinness
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - Jen-Chywan Wang
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
| | - Richard M O'Brien
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., J.K.O., O.P.M., R.M.O.) and Medicine (C.D.), Vanderbilt University School of Medicine, Nashville, Tennessee 37232; and Department of Nutritional Sciences and Toxicology (R.A.L., J.-C.W.), University of California at Berkeley, Berkeley, California 94720
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Slentz CA, Bateman LA, Willis LH, Granville EO, Piner LW, Samsa GP, Setji TL, Muehlbauer MJ, Huffman KM, Bales CW, Kraus WE. Effects of exercise training alone vs a combined exercise and nutritional lifestyle intervention on glucose homeostasis in prediabetic individuals: a randomised controlled trial. Diabetologia 2016; 59:2088-98. [PMID: 27421729 PMCID: PMC5026926 DOI: 10.1007/s00125-016-4051-z] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/23/2016] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Although the Diabetes Prevention Program (DPP) established lifestyle changes (diet, exercise and weight loss) as the 'gold standard' preventive therapy for diabetes, the relative contribution of exercise alone to the overall utility of the combined diet and exercise effect of DPP is unknown; furthermore, the optimal intensity of exercise for preventing progression to diabetes remains very controversial. To establish clinical efficacy, we undertook a study (2009 to 2013) to determine: how much of the effect on measures of glucose homeostasis of a 6 month programme modelled after the first 6 months of the DPP is due to exercise alone; whether moderate- or vigorous-intensity exercise is better for improving glucose homeostasis; and to what extent amount of exercise is a contributor to improving glucose control. The primary outcome was improvement in fasting plasma glucose, with improvement in plasma glucose AUC response to an OGTT as the major secondary outcome. METHODS The trial was a parallel clinical trial. Sedentary, non-smokers who were 45-75 year old adults (n = 237) with elevated fasting glucose (5.28-6.94 mmol/l) but without cardiovascular disease, uncontrolled hypertension, or diabetes, from the Durham area, were studied at Duke University. They were randomised into one of four 6 month interventions: (1) low amount (42 kJ kg body weight(-1) week(-1) [KKW])/moderate intensity: equivalent of expending 42 KKW (e.g. walking ∼16 km [8.6 miles] per week) with moderate-intensity (50% [Formula: see text]) exercise; (2) high amount (67 KKW)/moderate intensity: equivalent of expending 67 KKW (∼22.3 km [13.8 miles] per week) with moderate-intensity exercise; (3) high amount (67 KKW)/vigorous intensity: equivalent to group 2, but with vigorous-intensity exercise (75% [Formula: see text]); and (4) diet + 42 KKW moderate intensity: same as group 1 but with diet and weight loss (7%) to mimic the first 6 months of the DPP. Computer-generated randomisation lists were provided by our statistician (G. P. Samsa). The randomisation list was maintained by L. H. Willis and C. A. Slentz with no knowledge of or input into the scheduling, whereas all scheduling was done by L. A. Bateman, with no knowledge of the randomisation list. Subjects were automatically assigned to the next group listed on the randomisation sheet (with no ability to manipulate the list order) on the day that they came in for the OGTT, by L. H. Willis. All plasma analysis was done blinded by the individuals doing the measurements (i.e. lipids, glucose, insulin). Subjects and research staff (other than individuals analysing the blood) were not blinded to the group assignments. RESULTS Number randomised, completers and number analysed with complete OGTT data for each group were: low-amount/moderate-intensity (61, 43, 35); high-amount/moderate-intensity (61, 44, 40); high-amount/vigorous-intensity (61, 43, 38); diet/exercise (54, 45, 37), respectively. Only the diet and exercise group experienced a decrease in fasting glucose (p < 0.001). The means and 95% CIs for changes in fasting glucose (mmol/l) for each group were: high-amount/moderate-intensity -0.07 (-0.20, 0.06); high-amount/vigorous 0.06 (-0.07, 0.19); low-amount/moderate 0.05 (-0.05, 0.15); and diet/exercise -0.32 (-0.46, -0.18). The effects sizes for each group (in the same order) were: 0.17, 0.15, 0.18 and 0.71, respecively. For glucose tolerance (glucose AUC of OGTT), similar improvements were observed for the diet and exercise (8.2% improvement, effect size 0.73) and the 67 KKW moderate-intensity exercise (6.4% improvement, effect size 0.60) groups; moderate-intensity exercise was significantly more effective than the same amount of vigorous-intensity exercise (p < 0.0207). The equivalent amount of vigorous-intensity exercise alone did not significantly improve glucose tolerance (1.2% improvement, effect size 0.21). Changes in insulin AUC, fasting plasma glucose and insulin did not differ among the exercise groups and were numerically inferior to the diet and exercise group. CONCLUSIONS/INTERPRETATION In the present clinical efficacy trial we found that a high amount of moderate-intensity exercise alone was very effective at improving oral glucose tolerance despite a relatively modest 2 kg change in body fat mass. These data, combined with numerous published observations of the strong independent relation between postprandial glucose concentrations and prediction of future diabetes, suggest that walking ∼18.2 km (22.3 km prescribed with 81.6% adherence in the 67 KKW moderate-intensity group) per week may be nearly as effective as a more intensive multicomponent approach involving diet, exercise and weight loss for preventing the progression to diabetes in prediabetic individuals. These findings have important implications for the choice of clinical intervention to prevent progression to type 2 diabetes for those at high risk. TRIAL REGISTRATION ClinicalTrials.gov NCT00962962 FUNDING: The study was funded by National Institutes for Health National Institute of Diabetes and Digestive and Kidney Diseases (NIH-NDDK) (R01DK081559).
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Affiliation(s)
- Cris A Slentz
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA.
| | - Lori A Bateman
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA
- University of North Carolina at Chapel Hill, Center for Health Promotion and Disease Prevention, Chapel Hill, NC, USA
| | - Leslie H Willis
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA
| | - Esther O Granville
- Division of Geriatrics, Duke University School of Medicine, Durham, NC, USA
| | - Lucy W Piner
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA
| | - Gregory P Samsa
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Tracy L Setji
- Division of Endocrinology, Duke University School of Medicine, Durham, NC, USA
| | - Michael J Muehlbauer
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA
| | - Connie W Bales
- Division of Geriatrics, Duke University School of Medicine, Durham, NC, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA
- Division of Cardiology, Duke University School of Medicine, Durham,, NC, USA
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Functional Analysis of Mouse G6pc1 Mutations Using a Novel In Situ Assay for Glucose-6-Phosphatase Activity and the Effect of Mutations in Conserved Human G6PC1/G6PC2 Amino Acids on G6PC2 Protein Expression. PLoS One 2016; 11:e0162439. [PMID: 27611587 PMCID: PMC5017610 DOI: 10.1371/journal.pone.0162439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 08/23/2016] [Indexed: 11/19/2022] Open
Abstract
Elevated fasting blood glucose (FBG) has been associated with increased risk for development of type 2 diabetes. Single nucleotide polymorphisms (SNPs) in G6PC2 are the most important common determinants of variations in FBG in humans. Studies using G6pc2 knockout mice suggest that G6pc2 regulates the glucose sensitivity of insulin secretion. G6PC2 and the related G6PC1 and G6PC3 genes encode glucose-6-phosphatase catalytic subunits. This study describes a functional analysis of 22 non-synonymous G6PC2 SNPs, that alter amino acids that are conserved in human G6PC1, mouse G6pc1 and mouse G6pc2, with the goal of identifying variants that potentially affect G6PC2 activity/expression. Published data suggest strong conservation of catalytically important amino acids between all four proteins and the related G6PC3 isoform. Because human G6PC2 has very low glucose-6-phosphatase activity we used an indirect approach, examining the effect of these SNPs on mouse G6pc1 activity. Using a novel in situ functional assay for glucose-6-phosphatase activity we demonstrate that the amino acid changes associated with the human G6PC2 rs144254880 (Arg79Gln), rs149663725 (Gly114Arg) and rs2232326 (Ser324Pro) SNPs reduce mouse G6pc1 enzyme activity without affecting protein expression. The Arg79Gln variant alters an amino acid mutation of which, in G6PC1, has previously been shown to cause glycogen storage disease type 1a. We also demonstrate that the rs368382511 (Gly8Glu), rs138726309 (His177Tyr), rs2232323 (Tyr207Ser) rs374055555 (Arg293Trp), rs2232326 (Ser324Pro), rs137857125 (Pro313Leu) and rs2232327 (Pro340Leu) SNPs confer decreased G6PC2 protein expression. In summary, these studies identify multiple G6PC2 variants that have the potential to be associated with altered FBG in humans.
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Boortz KA, Syring KE, Dai C, Pound LD, Oeser JK, Jacobson DA, Wang JC, McGuinness OP, Powers AC, O'Brien RM. G6PC2 Modulates Fasting Blood Glucose In Male Mice in Response to Stress. Endocrinology 2016; 157:3002-8. [PMID: 27300767 PMCID: PMC4967123 DOI: 10.1210/en.2016-1245] [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] [Indexed: 02/06/2023]
Abstract
The glucose-6-phosphatase catalytic 2 (G6PC2) gene is expressed specifically in pancreatic islet beta cells. Genome-wide association studies have shown that single nucleotide polymorphisms in the G6PC2 gene are associated with variations in fasting blood glucose (FBG) but not fasting plasma insulin. Molecular analyses examining the functional effects of these single nucleotide polymorphisms demonstrate that elevated G6PC2 expression is associated with elevated FBG. Studies in mice complement these genome-wide association data and show that deletion of the G6pc2 gene lowers FBG without affecting fasting plasma insulin. This suggests that, together with glucokinase, G6PC2 forms a substrate cycle that determines the glucose sensitivity of insulin secretion. Because genome-wide association studies and mouse studies demonstrate that elevated G6PC2 expression raises FBG and because chronically elevated FBG is detrimental to human health, increasing the risk of type 2 diabetes, it is unclear why G6PC2 evolved. We show here that the synthetic glucocorticoid dexamethasone strongly induces human G6PC2 promoter activity and endogenous G6PC2 expression in isolated human islets. Acute treatment with dexamethasone selectively induces endogenous G6pc2 expression in 129SvEv but not C57BL/6J mouse pancreas and isolated islets. The difference is due to a single nucleotide polymorphism in the C57BL/6J G6pc2 promoter that abolishes glucocorticoid receptor binding. In 6-hour fasted, nonstressed 129SvEv mice, deletion of G6pc2 lowers FBG. In response to the stress of repeated physical restraint, which is associated with elevated plasma glucocorticoid levels, G6pc2 gene expression is induced and the difference in FBG between wild-type and knockout mice is enhanced. These data suggest that G6PC2 may have evolved to modulate FBG in response to stress.
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Affiliation(s)
- Kayla A Boortz
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Kristen E Syring
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Chunhua Dai
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Lynley D Pound
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - James K Oeser
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - David A Jacobson
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Jen-Chywan Wang
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Owen P McGuinness
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Alvin C Powers
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
| | - Richard M O'Brien
- Departments of Molecular Physiology and Biophysics (K.A.B., K.E.S., L.D.P., J.K.O., D.A.J., O.P.M., R.M.O.) and Medicine (C.D., A.C.P.), Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System (A.C.P.), Nashville, Tennessee 37232-0615; and Department of Nutritional Sciences and Toxicology (J.-C.W.), University of California, Berkeley, Berkeley, California 94720-3104
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Chandra DN, Bardosono S. The effect of fiber-rich milk and equi-carbohydrate snack on glycemic and insulin response and satiety feeling. MEDICAL JOURNAL OF INDONESIA 2016. [DOI: 10.13181/mji.v25i2.1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Additional dietary fibers which can decrease the glycemic response by slowing down digestion whilst maintaining the available carbohydrate content is one approach of healthy diet. This study aimed to compare post-prandial glycemic and insulin response, hunger and satiety feeling after consuming fiber-rich milk compare with equi-carbohydrate food as morning snack in healthy adults.Methods: Cross-over study was conducted on 12 healthy subjects who fulfilled the criteria. Each test food was given after consuming standard breakfast. Venous blood samples for insulin and glucose level were taken before consuming test food, at 30, 60, 120, and 180 minutes after, and plotted against time to generate a curve. Hunger and satiety assessments were taken by visual analog scale (VAS) after each blood sampling.Results: In average, age was 30.8+4.3 years old, body mass index was 20.6±1.6 kg/m2. Seven of twelve subjects were females. There were significantly differences in postprandial glycemic response (p<0.001), insulin response (p=0.045) and hunger feeling (p=0.021) between the two foods. However, postprandial satiety feelings were not different significantly (p=0.357). The glycemic response area under the curve of fiber-rich milk was significantly lower than the equi-carbohydrate snack (p=0.010). Conclusion: Differences in glycemic and insulin response, and hunger feeling between two test foods, suggesting that fiber-rich milk can be used as an alternative snack for healthy adults. Further study is needed for the use of fiber-rich milk as an alternative snack for pre-diabetic patients.
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Singh S, Netticadan T, Ramdath DD. Expression of cardiac insulin signalling genes and proteins in rats fed a high-sucrose diet: effect of bilberry anthocyanin extract. GENES AND NUTRITION 2016; 11:8. [PMID: 27482298 PMCID: PMC4959554 DOI: 10.1186/s12263-016-0516-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 01/09/2016] [Indexed: 12/16/2022]
Abstract
Scope Insulin resistance is associated with impaired cardiac function, but the underlying molecular abnormalities are largely unexplained. Bilberry anthocyanin (BAcn) may be protective, as it appears to potentiate insulin action. Methods Rats were randomly allocated to control, sucrose-fed (SF) or sucrose-fed + BAcn diets (SF-A) for 15 weeks. Cardiac insulin signalling genes and proteins were quantified using reverse transcription quantitative real-time polymerase chain reaction and western blots. Results Glucose tolerance was not different with treatment. SF showed lower (p < 0.05) ferric reducing antioxidant power, which increased with BAcn. SF resulted in significantly decreased (p < 0.05) expression of 10 genes: acetyl-coenzyme A carboxylase alpha; V-Akt murine thymoma viral oncogene homolog 1; Bcl2-like 1; cytosine-cytosine-adenosine-adenosine-thymidine/enhancer binding protein; FK506 binding protein 12-rapamycin associated; glycerol-3-phosphate dehydrogenase 1 (soluble); solute carrier family 2 (facilitated glucose transporter), member 1, 4; hexokinase 2; and thyroglobulin. SF-A prevented these changes. Compared to SF-A, SF up-regulated (p < 0.05) complement factor D and phosphoinositide-3-kinase, regulatory subunit1 (α); sterol regulatory element binding transcription factor 1 was down-regulated (p < 0.05). SF increased (p < 0.05) cardiac phospholamban and decreased phosphorylated troponin I, which were not attenuated by BAcn. Compared to control or SF, SF-A resulted in significantly lower (p < 0.05) 5′-AMP-activated protein kinase. Conclusions SF lowered antioxidant capacity and changed the expression of insulin signalling genes, which were modulated by BAcn.
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Affiliation(s)
- Shamjeet Singh
- Department of Pre-Clinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago West Indies
| | - Thomas Netticadan
- Canadian Centre for Agri-Food Research in Health and Medicine, 351 Taché Avenue, Winnipeg, Manitoba Canada
| | - D Dan Ramdath
- Department of Pre-Clinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago West Indies ; Guelph Food Research Centre, Agriculture and Agri-Food Canada, 93 Stone Road West, Guelph, ON N1G 5C9 Canada
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Yang HK, Ha HS, Rhee M, Lee JH, Park YM, Kwon HS, Yim HW, Kang MI, Lee WC, Son HY, Lee SH, Yoon KH. Predictive Value of Glucose Parameters Obtained From Oral Glucose Tolerance Tests in Identifying Individuals at High Risk for the Development of Diabetes in Korean Population. Medicine (Baltimore) 2016; 95:e3053. [PMID: 26962830 PMCID: PMC4998911 DOI: 10.1097/md.0000000000003053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Previous studies suggest that the future risk for type 2 diabetes is not similar among subjects in the same glucose tolerance category. In this study, we aimed to evaluate simple intuitive indices to identify subjects at high risk for future diabetes development by using 0, 30, 120 minute glucose levels obtained during 75 g OGTTs from participants of a prospective community-based cohort in Korea.Among subjects enrolled at the Chungju Metabolic disease Cohort, those who performed an OGTT between 2007 and 2010 and repeated the test between 2011 and 2014 were recruited after excluding subjects with diabetes at baseline. Subjects were categorized according to their 30 minute glucose (G30) and the difference between 120 and 0 minute glucose (G(120-0)) levels with cutoffs of 9.75 and 2.50 mmol/L, respectively.Among 1126 subjects, 117 (10.39%) developed type 2 diabetes after 4 years. In diabetes nonconverters, increased insulin resistance was accompanied by compensatory insulin secretion, but this was not observed in converters during 4 years of follow-up. Subjects with G(120-0) ≥ 2.50 mmol/L or G30 ≥ 9.75 mmol/L demonstrated lower degrees of insulin secretion, higher degrees of insulin resistance, and ∼6-fold higher risk of developing future diabetes compared to their lower counterparts after adjustment for possible confounding factors. Moreover, subjects with high G(120-0) and high G30 demonstrated 22-fold higher risk for diabetes development compared to subjects with low G(120-0) and low G30.By using the G(120-0) and G30 values obtained during the OGTT, which are less complicated measurements than previously reported methods, we were able to select individuals at risk for future diabetes development. Further studies in different ethnicities are required to validate our results.
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Affiliation(s)
- Hae Kyung Yang
- From the Division of Endocrinology and Metabolism (HKY, S-HL, K-HY, MR, H-SK, M-IK), Department of Internal Medicine, College of Medicine, The Catholic University of Korea; Division of Endocrinology and Metabolism (HKY, S-HL, K-HY, M-IK), Department of Internal Medicine, Seoul St. Mary's Hospital; Department of Preventive Medicine (H-SH, H-WY, W-CL), College of Medicine, The Catholic University of Korea; Catholic Institute of U-Healthcare (J-HL), The Catholic University of Korea, Seoul, Korea; Epidemiology Branch (Y-MP), National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC; Division of Endocrinology and Metabolism (H-SK), Department of Internal Medicine, Yeouido St.Mary's Hospital; and Division of Endocrinology and Metabolism (H-YS), Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
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Katayama H, Tachibana D, Hamuro A, Misugi T, Motoyama K, Morioka T, Fukumoto S, Emoto M, Inaba M, Koyama M. Sustained Decrease of Early-Phase Insulin Secretion in Japanese Women with Gestational Diabetes Mellitus Who Developed Impaired Glucose Tolerance and Impaired Fasting Glucose Postpartum. JAPANESE CLINICAL MEDICINE 2015; 6:35-9. [PMID: 26688669 PMCID: PMC4675641 DOI: 10.4137/jcm.s32743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 10/29/2015] [Accepted: 10/31/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this study was to compare glucose intolerance in the antenatal and the postpartum periods using a 75-g oral glucose tolerance test (OGTT) in the Japanese women with gestational diabetes mellitus (GDM) using a retrospective design. PATIENTS AND METHODS Data were obtained from 85 Japanese women with GDM who delivered from April 2011 through April 2015 and who underwent an OGTT 6–14 weeks postpartum. The women were divided into two groups based on the results of the postpartum OGTT: one group with normal glucose tolerance (NGT) and the other with impaired glucose tolerance (IGT) as well as impaired fasting glucose (IFG). We analyzed the associations between postpartum IGT–IFG and various factors. RESULTS Antenatally, a significant difference was observed between the groups only in the 1-hour plasma glucose level of the 75-g OGTT. Postpartum results of plasma glucose level were significantly higher at 0.5, 1, and 2 hours in the IGT–IFG group than those in the NGT group. Moreover, a significant decrease in the levels of 0.5-hour immunoreactive insulin and insulinogenic index was observed in the IGT–IFG group compared to those in the NGT group. Homeostasis model assessment-insulin resistance and homeostasis model assessment β-cell function of both groups were found to significantly decrease in the postpartum period; however, there was no significant change in the insulinogenic index of either group. CONCLUSIONS Our study clearly showed that the postpartum IGT and IFG levels of Japanese women with GDM are affected by impaired early-phase insulin secretion; however, insulin resistance promptly improves.
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Affiliation(s)
- Hiroko Katayama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Daisuke Tachibana
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Akihiro Hamuro
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Takuya Misugi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Koka Motoyama
- Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Tomoaki Morioka
- Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Shinya Fukumoto
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
| | - Masayasu Koyama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka City University, Asahimachi, Abeno-ku, Osaka, Japan
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Cao X, Yang C, Lai F, Hong Z, Lin H, Liu J, Li Y. Elevated circulating level of a cytokine, pancreatic-derived factor, is associated with metabolic syndrome components in a Chinese population. J Diabetes Investig 2015; 7:581-6. [PMID: 27181109 PMCID: PMC4931209 DOI: 10.1111/jdi.12437] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/14/2015] [Accepted: 10/01/2015] [Indexed: 01/10/2023] Open
Abstract
Aims/Introduction Pancreatic‐derived factor (PANDER) is an important factor involved in obesity, glucose intolerance and abnormal lipid metabolism in animals. Nevertheless, the relationship between PANDER and metabolic syndrome (MetS) in humans has not yet been reported. Materials and Methods To determinate the relationship between PANDER and MetS components, 212 individuals aged between 40 and 65 years were recruited. Fasting plasma PANDER and other variables were measured. Correlations of plasma PANDER and other variables were carried out. Plasma PANDER level was compared in participants with no metabolic components and those with any metabolic components, as well as in normal glucose tolerance, impaired glucose tolerance and diabetes mellitus participants. Results In all the participants, there were 65 participants in the no metabolic components group and 147 participants in the any metabolic components group. Plasma PANDER level was increased with the number of MetS components (P < 0.05) and correlated with metabolic score (r = 0. 529, P < 0.001). In addition, plasma PANDER significantly correlated with fasting plasma glucose (r = 0.187, P = 0.046), 2‐h plasma glucose (r = 0.195, P = 0.035), homeostasis model assessment of β‐cell function (r = −0.191, P = 0.039), triglyceride (r = 0.305, P = 0.001) and high‐density lipoprotein cholesterol (r = −0.333, P < 0.001). Using multivariable logistic regression analysis, circulating PANDER was associated with an increased risk ratio of impaired glucose tolerance or diabetes mellitus (odds ratio 2.22, 95% confidence interval 1.15–4.42, P = 0.018) after adjustment of the other possible confounders. Conclusions Circulating level of PANDER in relation to the accumulation in MetS suggested that persons with elevated levels of PANDER were associated with an increased risk of metabolic syndrome.
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Affiliation(s)
- Xiaopei Cao
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chijiao Yang
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fenghua Lai
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhenzhen Hong
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huimei Lin
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Juan Liu
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Kanat M, DeFronzo RA, Abdul-Ghani MA. Treatment of prediabetes. World J Diabetes 2015; 6:1207-1222. [PMID: 26464759 PMCID: PMC4598604 DOI: 10.4239/wjd.v6.i12.1207] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/12/2015] [Accepted: 09/08/2015] [Indexed: 02/05/2023] Open
Abstract
Progression of normal glucose tolerance (NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance (IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus (type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options (lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.
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Kuang L, Huang Z, Hong Z, Chen A, Li Y. Predictability of 1-h postload plasma glucose concentration: A 10-year retrospective cohort study. J Diabetes Investig 2015; 6:647-54. [PMID: 26543538 PMCID: PMC4627541 DOI: 10.1111/jdi.12353] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/23/2015] [Accepted: 03/12/2015] [Indexed: 11/30/2022] Open
Abstract
Aims/Introduction Elevated 1-h postload plasma glucose concentration (1hPG) during oral glucose tolerance test has been linked to an increased risk of type 2 diabetes and a poorer cardiometabolic risk profile. The present study analyzed the predictability and cut-off point of 1hPG in predicting type 2 diabetes in normal glucose regulation (NGR) subjects, and evaluated the long-term prognosis of NGR subjects with elevated 1hPG in glucose metabolism, kidney function, metabolic states and atherosclerosis. Materials and Methods A total of 116 Han Chinese classified as NGR in 2002 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China, were investigated. Follow-up was carried out in 2012 to evaluate the progression of glucose metabolism, kidney function, metabolic syndrome and carotid atherosclerosis. Results The areas under receiver operating characteristic curves were higher for 1hPG than FPG or 2hPG (0.858 vs 0.806 vs 0.746). The cut-off value of 1hPG with the maximal sum of sensitivity and specificity in predicting type 2 diabetes in NGR subjects was 8.85 mmol/L. The accumulative incidence of type 2 diabetes in subjects with 1hPG ≥8.85 mmol/L was higher than those <8.85 mmol/L (46.2% vs 3.3%, P = 0.000; relative risk 13.846, 95% confidence interval 4.223–45.400). On follow up, the prevalence of metabolic syndrome and abnormal carotid intima-media thickness in the subjects with 1hPG ≥8.85 mmol/L tended to be higher compared with those <8.85 mmol/L. Conclusions 1hPG is a good predictor of type 2 diabetes in NGR subjects, and the best cut-off point is 8.85 mmol/L. Some tendency indicates that NGR subjects with 1hPG ≥8.85 mmol/L are more prone to metabolic syndrome and carotid atherosclerosis.
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Affiliation(s)
- Lifen Kuang
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Zhimin Huang
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Zhenzhen Hong
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Ailing Chen
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Yanbing Li
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
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Patel SM, Cobb P, Saydah S, Zhang X, de Jesus JM, Cogswell ME. Dietary sodium reduction does not affect circulating glucose concentrations in fasting children or adults: findings from a systematic review and meta-analysis. J Nutr 2015; 145:505-13. [PMID: 25733466 PMCID: PMC4336531 DOI: 10.3945/jn.114.195982] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although evidence shows that reduced sodium intake lowers blood pressure, some studies suggest that sodium reduction may adversely affect insulin resistance and glucose tolerance. OBJECTIVES The objectives were to assess the effects of sodium reduction on glucose tolerance, evaluate strengths and weaknesses of the relevant scientific literature, and provide direction for future research. METHODS We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, and Web of Science through August 2014. Both randomized and nonrandomized intervention trials were included in our meta-analyses. The effects of sodium reduction on glucose tolerance were evaluated in 37 articles, but because of a lack of comparable data, 8 trials were excluded from the meta-analyses. RESULTS Participants were 10-79 y old, either primarily healthy or with hypertension. In meta-analyses of 20 randomized, crossover trials (n = 504 participants) and 9 nonrandomized crossover trials (n = 337), circulating glucose concentrations of fasting participants were not affected by reduction in sodium intake. In contrast, in meta-analyses of 19 of the 20 randomized, crossover trials (n = 494), fasting insulin concentrations were 9.53 pmol/L higher (95% CI: 5.04, 14.02 pmol/L higher) with sodium reduction. In 9 nonrandomized trials (n = 337), fasting insulin did not differ with reduced sodium intake. Results differed little when the analyses were restricted to studies with a low risk of bias and duration of ≥7 d. CONCLUSIONS This meta-analysis revealed no evidence that, in trials with a short intervention and large reductions in sodium, circulating glucose concentrations differed between groups. Recommendations for future studies include extending intervention durations, ensuring comparability of groups at baseline through randomization, and assessing sodium intakes relevant to population sodium reduction. In addition, analyses on other metabolic variables were limited because of the number of trials reporting these outcomes and lack of consistency across measures, suggesting a need for comparable measures of glucose tolerance across studies.
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Affiliation(s)
- Sheena M Patel
- Divisions of Heart Disease and Stroke Prevention and Oak Ridge Institute for Science and Education, Atlanta, GA; and
| | - Paul Cobb
- Divisions of Heart Disease and Stroke Prevention and
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48
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Wagenmakers AJM, Strauss JA, Shepherd SO, Keske MA, Cocks M. Increased muscle blood supply and transendothelial nutrient and insulin transport induced by food intake and exercise: effect of obesity and ageing. J Physiol 2015; 594:2207-22. [PMID: 25627798 DOI: 10.1113/jphysiol.2014.284513] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/20/2015] [Indexed: 01/07/2023] Open
Abstract
This review concludes that a sedentary lifestyle, obesity and ageing impair the vasodilator response of the muscle microvasculature to insulin, exercise and VEGF-A and reduce microvascular density. Both impairments contribute to the development of insulin resistance, obesity and chronic age-related diseases. A physically active lifestyle keeps both the vasodilator response and microvascular density high. Intravital microscopy has shown that microvascular units (MVUs) are the smallest functional elements to adjust blood flow in response to physiological signals and metabolic demands on muscle fibres. The luminal diameter of a common terminal arteriole (TA) controls blood flow through up to 20 capillaries belonging to a single MVU. Increases in plasma insulin and exercise/muscle contraction lead to recruitment of additional MVUs. Insulin also increases arteriolar vasomotion. Both mechanisms increase the endothelial surface area and therefore transendothelial transport of glucose, fatty acids (FAs) and insulin by specific transporters, present in high concentrations in the capillary endothelium. Future studies should quantify transporter concentration differences between healthy and at risk populations as they may limit nutrient supply and oxidation in muscle and impair glucose and lipid homeostasis. An important recent discovery is that VEGF-B produced by skeletal muscle controls the expression of FA transporter proteins in the capillary endothelium and thus links endothelial FA uptake to the oxidative capacity of skeletal muscle, potentially preventing lipotoxic FA accumulation, the dominant cause of insulin resistance in muscle fibres.
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Affiliation(s)
- Anton J M Wagenmakers
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Juliette A Strauss
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Sam O Shepherd
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Michelle A Keske
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Matthew Cocks
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
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Othman A, Saely CH, Muendlein A, Vonbank A, Drexel H, von Eckardstein A, Hornemann T. Plasma 1-deoxysphingolipids are predictive biomarkers for type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2015; 3:e000073. [PMID: 25815206 PMCID: PMC4368929 DOI: 10.1136/bmjdrc-2014-000073] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 01/29/2015] [Accepted: 02/24/2015] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Serine palmitoyltransferase (SPT) catalyzes the condensation of serine and palmitoyl coenzyme A, the first step in the de novo sphingolipid synthesis. Apart from these canonical substrates, SPT can also metabolize alanine and other acyl coenzyme As. This forms a spectrum of atypical sphingoid bases which are altered in the context of the metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM). We investigated whether atypical sphingolipids can be used as prospective markers to predict the incidence of T2DM. RESEARCH DESIGN AND METHODS Using liquid chromatography/mass spectrometry, we analyzed the sphingoid base profile in a prospective cohort with 339 individuals. All individuals were followed up for a period of 8 years. RESULTS Confirming earlier results, we found 1-deoxysphingolipids (1-deoxySLs) to be significantly elevated in patients with MetS, impaired fasting glucose, and T2DM. Patients who developed T2DM during the follow-up period (n=32) showed significantly higher 1-deoxySL levels at baseline compared with those who did not develop T2DM until the end of the study (n=70). 1-Deoxysphingosine levels were independent predictors for T2DM even after adjusting for glycated hemoglobin (standardized adjusted OR=2.1, CI 95% (1.19 to 3.71); p=0.010), MetS (standardized adjusted OR=1.97, CI 95% (1.13 to 3.43); p=0.017), and other risk factors such as age, sex, BMI, and lipid-lowering drugs. Similar results were observed for the 1-deoxysphinganine levels. CONCLUSIONS Our results support a novel role for 1-deoxySL as predictive biomarkers for the development of T2DM in risk patients and warrants further larger prospective trials in lower risk cohorts.
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Affiliation(s)
- Alaa Othman
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Institute of Experimental and Clinical Pharmacology and Toxicology, University of Lübeck, Lübeck, Germany
| | - Christoph H Saely
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Axel Muendlein
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Alexander Vonbank
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Arnold von Eckardstein
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Thorsten Hornemann
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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50
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Bergman M. The Early Diabetes Intervention Program--is early actually late? Diabetes Metab Res Rev 2014; 30:654-8. [PMID: 25400067 DOI: 10.1002/dmrr.2563] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 04/29/2014] [Indexed: 01/01/2023]
Abstract
This Commentary briefly reviews the background of prediabetes including its definition and pathophysiology and describes as well the natural course of glycemic deterioration as it follows a continuum. Research efforts in identifying glucose and other biomarkers for the early detection of high-risk individuals are summarized.
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Affiliation(s)
- Michael Bergman
- Diabetes and Endocrine Assoc, NYU School of Medicine, New York, NY, USA
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