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Chmiela T, Jarosz-Chobot P, Gorzkowska A. Glucose Metabolism Disorders and Parkinson's Disease: Coincidence or Indicator of Dysautonomia? Healthcare (Basel) 2024; 12:2462. [PMID: 39685083 DOI: 10.3390/healthcare12232462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 11/22/2024] [Accepted: 12/05/2024] [Indexed: 12/18/2024] Open
Abstract
Background: Parkinson's disease (PD) and type 2 diabetes mellitus (T2DM) are both age-related diseases. Evidence from recent studies suggests a link between them. The existence of an interaction between autonomic nervous system dysfunction and the dysregulation of glucose metabolism is one of the proposed mechanisms to explain the complicated relationship between these diseases. The aims of this study are to assess the incidence of glycemic dysregulation in people with PD and to identify clinical factors that may predispose patients with PD to the occurrence of metabolic disturbances. Methods: In total, 35 individuals diagnosed with PD and 20 healthy control subjects matched in terms of age and gender participated in a study consisting of clinical and biometric assessments along with 14 days of continuous glucose monitoring (CGM) using the Freestyle Libre system. In the group of patients with PD, a comparative analysis was performed between patients with and without autonomic dysfunction. The severity of autonomic dysfunction was assessed using the SCOPA-AUT. Results: Participants diagnosed with PD demonstrated a trend toward lower morning glucose levels compared to the control group. PD patients with autonomic symptoms had greater glucose variability and a deeper trend toward lower glucose levels in the mornings. The presence of autonomic dysfunction, especially orthostatic hypotension and micturition disturbance, and the severity of autonomic symptoms were associated with greater glycemic variability. Conclusions: The occurrence of autonomic disorders in the course of Parkinson's disease predisposes patients to more profound glycemic dysregulation.
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Affiliation(s)
- Tomasz Chmiela
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Przemysława Jarosz-Chobot
- Department of Children's Diabetology and Lifestyle Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Agnieszka Gorzkowska
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-752 Katowice, Poland
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Vara-Luiz F, Glória L, Mendes I, Carlos S, Guerra P, Nunes G, Oliveira CS, Ferreira A, Santos AP, Fonseca J. Chronic Intestinal Failure and Short Bowel Syndrome in Adults: The State of the Art. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2024; 31:388-400. [PMID: 39633906 PMCID: PMC11614447 DOI: 10.1159/000538938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/13/2024] [Indexed: 12/07/2024]
Abstract
Background Short bowel syndrome (SBS) is a devastating malabsorptive condition and the most common cause of chronic intestinal failure (CIF). During the intestinal rehabilitation process, patients may need parenteral support for months or years, parenteral nutrition (PN), or hydration/electrolyte supplementation, as a bridge for the desired enteral autonomy. Summary Several classification criteria have been highlighted to reflect different perspectives in CIF. The management of CIF-SBS in adults is a multidisciplinary process that aims to reduce gastrointestinal secretions, slow transit, correct/prevent malnutrition, dehydration, and specific nutrient deficiencies, and prevent refeeding syndrome. The nutritional support team should have the expertise to take care of these complex patients: fluid support; oral, enteral, and PN; disease/PN-related complications; pharmacologic treatment; and surgical prevention/treatment. Key Messages CIF-SBS is a complex disease with undesired consequences, if not adequately identified and managed. A comprehensive approach performed by a multidisciplinary team is essential to reduce PN dependence, promote enteral independence, and improve quality of life.
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Affiliation(s)
- Francisco Vara-Luiz
- GENE – Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
- Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - Luísa Glória
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Ivo Mendes
- GENE – Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Sandra Carlos
- Surgery Department, Hospital Garcia de Orta, Almada, Portugal
| | - Paula Guerra
- Pediatrics Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Gonçalo Nunes
- GENE – Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
- Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - Cátia Sofia Oliveira
- GENE – Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Andreia Ferreira
- Nutrition Department, Hospital Lusíadas Lisboa, Lisboa, Portugal
| | | | - Jorge Fonseca
- GENE – Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
- Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
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Nangia A, Saravanan JS, Hazra S, Priya V, Sudesh R, Rana SS, Ahmad F. Exploring the clinical connections between epilepsy and diabetes mellitus: Promising therapeutic strategies utilizing agmatine and metformin. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:9617-9632. [PMID: 39066910 DOI: 10.1007/s00210-024-03295-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Diabetes mellitus (DM) and epilepsy and the psychological and socio-economic implications that are associated with their treatments can be quite perplexing. Metformin is an antihyperglycemic medication that is used to treat type 2 DM. In addition, metformin elicits protective actions against multiple diseases, including neurodegeneration and epilepsy. Recent studies indicate that metformin alters the resident gut microbiota in favor of species producing agmatine, an arginine metabolite which, in addition to beneficially altering metabolic pathways, is a potent neuroprotectant and neuromodulant. METHODS We first examine the literature for epidemiological and clinical evidences linking DM and epilepsy. Next, basing our analyses on published literature, we propose the possible complementarity of agmatine and metformin in the treatment of DM and epilepsy. RESULTS Our analyses of the clinical data suggest a significant association between pathogeneses of epilepsy and DM. Further, both agmatine and metformin appear to be multimodal therapeutic agents and have robust antiepileptogenic and antidiabetic properties. Data from animal and clinical studies largely support the use of metformin/agmatine as a double-edged pharmacotherapeutic agent against DM and epilepsy, particularly in their concurrent pathological occurrences. CONCLUSION The present review explores the evidences and available data on possible uses of metformin/agmatine as pertinent antidiabetic and antiepileptic agents. Our hope is that this will stimulate further research on the therapeutic actions of these multimodal agents, particularly for subject-specific clinical outcomes.
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Affiliation(s)
- Aayushi Nangia
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Janani Srividya Saravanan
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Shruti Hazra
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Vijayan Priya
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Ravi Sudesh
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Sandeep Singh Rana
- Department of Biosciences, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Faraz Ahmad
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India.
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Qiu J, He S, Yu C, Yang R, Kuang M, Sheng G, Zou Y. Assessing the validity of METS-IR for predicting the future onset of diabetes: an analysis using time-dependent receiver operating characteristics. BMC Endocr Disord 2024; 24:238. [PMID: 39508243 PMCID: PMC11542444 DOI: 10.1186/s12902-024-01769-0] [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: 04/16/2024] [Accepted: 10/29/2024] [Indexed: 11/08/2024] Open
Abstract
BACKGROUND The Metabolic Insulin Resistance Score (METS-IR) is a non-invasive proxy for insulin resistance (IR) that has been newly developed in recent years and has been shown to be associated with diabetes risk. Our aim was to assess the predictive value of METS-IR for the future development of diabetes and its temporal differences in people of different sex, age, and body mass index (BMI). METHODS The current study included 15,453 baseline non-diabetic subjects in the NAGALA cohort and then grouped according to the World Health Organization's (WHO) recommended criteria for age and BMI. Multivariate Cox regression and time-dependent receiver operator characteristics (ROC) curves were used to analyze the value of METS-IR in assessing and predicting the risk of diabetes in people of different sexes, ages, and BMIs. RESULTS 373 individuals developed diabetes during the observation period. By multivariate COX regression analysis, the development of future diabetes was significantly associated with increased METS-IR, and this positive association was stronger in women than in men and in individuals < 45 years than in individuals ≥ 45 years; while no significant differences were observed between non-obese and overweight/obesity individuals. Using time-dependent ROC analysis we also assessed the predictive value of METS-IR for future diabetes at a total of 11-time points between 2 and 12 years. The results showed that METS-IR had a higher predictive value for the future development of diabetes in women or individuals < 45 years of age compared to men or individuals ≥ 45 years of age for almost the entire follow-up period. Furthermore, across different BMI categories, we also found that in the short term (3-5 years), METS-IR had a higher predictive value for the development of diabetes in individuals with overweight/obesity, while in the medium to long term (6-12 years), METS-IR was more accurate in predicting the development of diabetes in non-obese individuals. CONCLUSIONS Our study showed that METS-IR was independently associated with the development of future diabetes in a non-diabetic population. METS-IR was a good predictor of diabetes, especially for women and individuals < 45 years old for predicting the future risk of developing diabetes at all times.
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Affiliation(s)
- Jiajun Qiu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Shiming He
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Changhui Yu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Ruijuan Yang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Department of Endocrinology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Maobin Kuang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China.
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Li J, Wang D, Tian H, Yang J, Xia H, Guo W. Association between lipid accumulation products and stress urinary incontinence: a cross-sectional study from NHANES 2005 to 2018. Lipids Health Dis 2024; 23:358. [PMID: 39497148 PMCID: PMC11533302 DOI: 10.1186/s12944-024-02350-3] [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: 07/31/2024] [Accepted: 10/27/2024] [Indexed: 11/06/2024] Open
Abstract
BACKGROUND Stress urinary incontinence (SUI), a common disorder of the pelvic floor, often results in anxiety, poor quality of life, and psychological issues among its sufferers. The relationship between lipid accumulation products (LAP) and stress-related urine incontinence remains unclear. This research aimed to investigate any possible correlation between the risk of SUI and the level of lipid accumulation products. METHODS For this cross-sectional research, people with SUI who were 20 years of age or older were recruited using information from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. A weighted multivariate logistic regression model was used to evaluate the findings. As a potential biomarker, lipid accumulation product levels were sorted among individuals in ascending order and subjected to a trend test (P for trend). Additionally, a nonlinear analysis was conducted using smooth curve-fitting methods. Lipid accumulation products' effectiveness in predicting SUI was evaluated using receiver operating characteristic (ROC) curves. Finally, a subgroup analysis was performed to confirm that the connection between SUI and lipid accumulation products was consistent across all demographic groups. RESULTS A thorough survey performed on 14,945 participants indicated that 23.61% of the respondents had SUI. A noteworthy association was observed between higher lipid accumulation product values and a greater probability of SUI in multivariate logistic regression analysis. Specifically, the stratification of lipid accumulation products into quartiles demonstrated a substantial positive correlation between the upper and lower quartiles, as evidenced by an elevated odds ratio for SUI (OR = 1.92; 95%CI 1.51-2.44; P < 0.0001). The subgroup analysis supported link consistency across all cohorts under investigation. Finally, the ROC curve indicated that lipid accumulation products (AUC = 0.67, 95%CI 0.654-0.690) had a superior predictive effect on the likelihood of SUI. CONCLUSIONS Increased lipid accumulation product values are associated with a higher chance of SUI in adult participants. This suggests that lipid accumulation products could be a valuable marker for detecting SUI, offering new perspectives for its evaluation and treatment.
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Affiliation(s)
- JiHang Li
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Dong Wang
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Hu Tian
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - JianKun Yang
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
| | - Hui Xia
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
| | - WenBin Guo
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
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Paul J, Jani R, Thorning S, Obucina M, Davoren P, Knight-Agarwal C. Low carbohydrate diets, glycaemic control, enablers, and barriers in the management of type 1 diabetes: a mixed methods systematic review. Diabetol Metab Syndr 2024; 16:261. [PMID: 39487521 PMCID: PMC11531154 DOI: 10.1186/s13098-024-01496-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 10/21/2024] [Indexed: 11/04/2024] Open
Abstract
BACKGROUND Medical nutrition therapy is fundamental for diabetes management, however there is a lack of evidence supporting an ideal recommended carbohydrate intake for maintaining optimal glycaemia in individuals living with type 1 diabetes (T1D). Adults with T1D are increasingly drawn to very low carbohydrate (≤ 50 g/day or < 10% total energy intake) and low carbohydrate diets (< 130 g/day or < 26% total energy intake) because of the reported positive impact on both physical health and psychological well-being. Current evidence regarding the effectiveness on glycaemia and the lived experience by adults with T1D when using these diets is limited. This mixed methods systematic review was undertaken to examine the effectiveness of very low and low carbohydrate diets on HbA1c and explore the lived experience of adults with T1D who have followed these dietary regimens. METHODS Seven databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Informit Health Collection, Web of Science, and PsycInfo) were searched from inception to 1 October 2023. Quality assessment of the included studies was undertaken using the JBI's critical appraisal checklists. Separate quantitative and qualitative synthesis was performed, and findings were integrated for the purpose of comparison and complementarity. RESULTS Seventeen studies of varying methodologies were included. Findings from quantitative research were inconclusive in determining the effectiveness of very low and low carbohydrate diets on HbA1c levels. Qualitative data synthesis identified four themes [1) Motivation to follow the diet, 2) Health benefits of the diet, 3) Challenges of the diet, and 4) Limited information (participants knowledge, information sources) about the diet] that influenced adherence to very low and low carbohydrate diets. Through the integration of results from selected studies, it was evident that there were conflicting outcomes between quantitative and qualitative studies. CONCLUSIONS There is little evidence to indicate that very low and low carbohydrate diets improve HbA1c in adults with T1D. However, this goes against the reported lived experiences of participants. This review highlights the insufficiency of robust evidence on this topic. Future research involving larger participant samples over longer durations are needed to provide more definitive evidence in relation to the efficacy of these diets and into the enablers and barriers experienced when using a very low or low carbohydrate diet in order to provide support to adults with T1D. Systematic review registration PROSPERO CRD42023482800.
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Affiliation(s)
- Janine Paul
- School of Clinical Science, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia.
- Diabetes and Endocrinology, Adult Outpatient Department, Gold Coast University Hospital and Health Service, 1 Hospital Boulevard, D Block, Area 4, Southport, QLD, 4215, Australia.
| | - Rati Jani
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, 4215, Australia
| | - Sarah Thorning
- Education and Research Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, 4700, Australia
| | - Mila Obucina
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, 4215, Australia
- Emergency Department, Gold Coast University Hospital and Health Service, Southport, QLD, 4215, Australia
| | - Peter Davoren
- Diabetes and Endocrinology, Adult Outpatient Department, Gold Coast University Hospital and Health Service, 1 Hospital Boulevard, D Block, Area 4, Southport, QLD, 4215, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, 4215, Australia
| | - Catherine Knight-Agarwal
- School of Clinical Science, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
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Ali M, Gupta A, Verma RD, Akhtar S, Ghosh JK. A peptide derived from the amino terminus of leptin improves glucose metabolism and energy homeostasis in myotubes and db/db mice. J Biol Chem 2024; 300:107919. [PMID: 39490585 PMCID: PMC11625344 DOI: 10.1016/j.jbc.2024.107919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 10/10/2024] [Accepted: 10/14/2024] [Indexed: 11/05/2024] Open
Abstract
Leptin is an adipokine, which plays key roles in regulation of glucose metabolism and energy homeostasis. Therefore, identification of a short peptide from leptin which improves glucose-metabolism and energy-homeostasis could be of significant therapeutic importance. Mutational studies demonstrated that N-terminal of human leptin hormone is crucial for activation of leptin-receptor while its C-terminal seems to have lesser effects in it. Thus, for finding a metabolically active peptide and complimenting the mutational studies on leptin, we have identified a 17-mer (leptin-1) and a 16-mer (leptin-2) segment from its N-terminal and C-terminal, respectively. Consistent with the mutational studies, leptin-1 improved glucose-metabolism by increasing glucose-uptake, GLUT4 expression and its translocation to the plasma membrane in L6-myotubes, while leptin-2 was mostly inactive. Leptin-1-induced glucose-uptake is mediated through activation of AMPK, PI3K, and AKT proteins since inhibitors of these proteins inhibited the event. Leptin-1 activated leptin-receptor immediate downstream target protein, JAK2 reflecting its possible interaction with leptin-receptor while leptin-2 was less active. Furthermore, leptin-1 increased mitochondrial-biogenesis and ATP-production, and increased expression of PGC1α, NRF1, and Tfam proteins, that are important regulators of mitochondrial biogenesis. The results suggested that leptin-1 improved energy-homeostasis in L6-myotubes, whereas, leptin-2 showed much lesser effects. In diabetic, db/db mice, leptin-1 significantly decreased blood glucose level and improved glucose-tolerance. Leptin-1 also increased serum adiponectin and decreased serum TNF-α and IL-6 level signifying the improvement in insulin-sensitivity and decrease in insulin-resistance, respectively in db/db mice. Overall, the results show the identification of a short peptide from the N-terminal of human leptin hormone which significantly improves glucose-metabolism and energy-homeostasis.
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Affiliation(s)
- Mehmood Ali
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Arvind Gupta
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Rahul Dev Verma
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Sariyah Akhtar
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Jimut Kanti Ghosh
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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Lu S, Kuang M, Qiu J, Li W, Zhang M, Sheng G, Zou Y, Peng X. Lipids as the link between central obesity and diabetes: perspectives from mediation analysis. BMC Endocr Disord 2024; 24:229. [PMID: 39468602 PMCID: PMC11514969 DOI: 10.1186/s12902-024-01764-5] [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: 06/26/2024] [Accepted: 10/22/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Central obesity is a well-recognized risk factor for diabetes, yet the potential role of lipids in the diabetes risk associated with central obesity remains unclear. This study aimed to explore the possible mediating role of 11 lipid parameters [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), non-high-density lipoprotein cholesterol (Non-HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), remnant cholesterol (RC), and ratios of Non-HDL-C/HDL-C, RC/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C] in the association of central obesity with diabetes risk. METHODS We utilized data from 15,453 participants in the NAGALA longitudinal cohort to assess the association of baseline central obesity indicators [waist-height ratio (WHtR), waist circumference (WC)] and the 11 lipid parameters with diabetes risk. Mediation analysis models were constructed to explore the mediating role of lipid parameters in the association of WC/WHtR with diabetes. RESULTS Confirmatory associative analysis using multivariable Cox regression showed that, except for Non-HDL-C, TC and LD-C, the remaining eight lipid parameters were significantly associated with WC/WHtR and diabetes risk. Mediation analysis indicated that TG, RC, HDL-C, and lipid ratios such as Non-HDL-C/HDL-C ratio, RC/HDL-C ratio, TG/HDL-C ratio, TC/HDL-C ratio and LDL/HDL-C ratio are potential lipids affecting the diabetes risk related to central obesity. Among these, the RC/HDL-C ratio seemed to contribute the most in the WC/WHtR-related diabetes risk association, with a mediation percentage of about 37%. Additionally, lipid ratio parameters appeared to play a more mediating role in the association of central obesity-related diabetes risk than individual lipids. CONCLUSIONS In central obesity-related diabetes risk, most lipids, especially lipid ratio parameters, play a significant mediating role. Given these findings, we advocate for increased efforts in multifactorial risk monitoring and joint management of diabetes. The evaluation of lipids, particularly lipid ratio parameters, may be holds substantial value in the prevention and management of diabetes risk under close monitoring of central obesity.
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Affiliation(s)
- Song Lu
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Maobin Kuang
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Jiajun Qiu
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Wenjuan Li
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, 330047, China
| | - Min Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China.
| | - Xiaoping Peng
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
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Godevithana J, Wijesinghe CJ. Barriers and facilitators for universal gestational diabetes Mellitus screening in a low resource setting: a cross-sectional study in Sri Lanka. Sci Rep 2024; 14:25253. [PMID: 39448718 PMCID: PMC11502771 DOI: 10.1038/s41598-024-76863-3] [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: 07/22/2024] [Accepted: 10/17/2024] [Indexed: 10/26/2024] Open
Abstract
Gestational Diabetes Mellitus (GDM) is associated with adverse maternal and perinatal outcomes and increased risk of developing diabetes in later life. Sri Lanka adopted universal GDM screening at two time points in pregnancy (before 12 weeks and between 24 and 28 weeks) in 2014 and its utilization has not been assessed. This study assessed the utilization of GDM screening services and associated factors among antenatal mothers in Southern Sri Lanka. A cross-sectional study was carried out in a consecutive sample of 420 postpartum mothers who delivered at three major hospitals in Sri Lanka. Data were collected on socio-demographics, pregnancy, availability and utilization of screening services and logistics using an interviewer-administered questionnaire and a data record sheet. Data was analysed using SPSS software. Chi-square test and binary logistic regression was used to assess the association between variables. The coverage of first and second screening tests were 91.4% and 94.5% and timeliness were 72.4% and 59.5%, respectively. The median period of amenorrhoea at the first and second screening were 10.0 (inter-quartile range: 2.5) weeks and 28.0 (inter-quartile range: 1.5) weeks. A higher utilization was associated with higher income (OR = 3.4, 95% CI: 1.1-10.5) and planned pregnancy (OR = 4.9, 95% CI: 2.2-10.7) for the first screening test. Primiparity (OR = 0.3, 95% CI: 0.1-0.9) and proximity of the nearest laboratory (OR = 3.5, 95% CI: 1.0-12.0) were positively associated with the second screening test. The timeliness of both screening tests was associated with planned pregnancy (OR = 2.1, 95% CI: 1.1-4.0 and OR = 2.3, 95% CI: 1.1-4.5) and being non-employed during the pregnancy (OR = 2.5, 95% CI: 1.4-4.3 and OR = 2.3, 95% CI: 1.3-4.1). A high utilization of GDM screening was observed. Timeliness should be ensured through improved availability and accessibility of screening facilities.
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Affiliation(s)
- Janaka Godevithana
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
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Jonusas J, Drevinskaitė M, Linkeviciute-Ulinskiene D, Ladukas A, Patašius A, Zabulienė L, Smailytė G. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study. Open Med (Wars) 2024; 19:20241017. [PMID: 39434861 PMCID: PMC11491771 DOI: 10.1515/med-2024-1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/25/2024] [Accepted: 07/18/2024] [Indexed: 10/23/2024] Open
Abstract
Objectives The aim of this study was to determine the association between insulin glargine usage and the potential increase in cancer risk among the Lithuanian population diagnosed with type 2 diabetes mellitus (T2DM). Methods A retrospective cohort study was conducted. The cohort of insulin users was established by identifying all male and female patients diagnosed with T2DM, as recorded in the National Health Insurance Fund database between 1 January 2000 and 31 December 2012. The risk of cancer among insulin glargine users was compared with the risk in non-glargine insulin users. Cox proportional hazard models were used to estimate hazard ratios (HR) and their 95% confidence intervals (CI). Results The overall cancer risk for all sites combined showed no significant difference (HR 0.84, 95% CI 0.67-1.05). Although a general decrease in the risk of cancers was observed at most sites for glargine users, the use of insulin glargine was associated with a non-significant increase in the risk of mouth and pharynx, stomach, non-melanoma skin, breast, cervical, ovarian, and central nervous system cancers. There was a tendency for a lower risk of colon, rectum, rectosigmoid, and anus cancer among glargine users (HR 0.45, 95% CI 0.18-1.12, p = 0.09). Conclusions Our research contributes to the growing body of evidence showing that insulin glargine is not associated with an increased risk of all cancers or specific types of cancer.
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Affiliation(s)
- Justinas Jonusas
- Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406, Vilnius, Lithuania
- Brachytherapy Department, National Cancer Institute, LT-08406, Vilnius, Lithuania
| | - Mingailė Drevinskaitė
- Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406, Vilnius, Lithuania
| | | | - Adomas Ladukas
- Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406, Vilnius, Lithuania
| | - Aušvydas Patašius
- Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406, Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101Vilnius, Lithuania
| | - Lina Zabulienė
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101, Vilnius, Lithuania
| | - Giedrė Smailytė
- Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406, Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101Vilnius, Lithuania
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11
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Chaudhary SK, Dikshit NA, Yadu N, Parihar A, Kohli N, Dwivedi DK. Efficacy of ultrasonography and color-Doppler for early prediction of hemodialysis arteriovenous fistula unassisted maturation. J Vasc Access 2024:11297298241282263. [PMID: 39340355 DOI: 10.1177/11297298241282263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Arteriovenous fistula (AVF) failure is a prevalent concern for patients with end-stage kidney disease on hemodialysis. Recognizing the efficacy of ultrasound Doppler in post-operative AVF evaluation, this study sought to discern the predictive capabilities of various ultrasonographic and color-Doppler metrics for early AVF outcomes. METHODS This single-center, prospective cohort study spanned 1 year and, post ethical clearance, included all patients who underwent native AVF creation surgery and were subsequently referred for standard post-operative ultrasound Doppler assessment. Parameters such as fistula size, cephalic vein area and diameter, and AVF flow velocity and rates were assessed on post-operative day 2, week 2, and week 6. These initial findings were juxtaposed with later outcomes to determine unassisted AVF results. RESULTS Of the initial cohort of 40 patients, 75% encountered AVF failure, whereas 25% realized successful unassisted AVF maturation. A notable observation was the significant variance in AVF flow rates as early as post-operative day 2. A threshold of >246 ml/min was indicative of successful unassisted AVF maturation, leading to a sensitivity of 80% and a specificity of 70%. Although the cephalic vein diameter on post-operative day 2 lacked a robust association with AVF outcomes, a cut-off of >3.4 mm, when combined with flow rate testing, augmented the cumulative sensitivity to 92%. CONCLUSION Ultrasound Doppler stands out as a valuable quantitative imaging modality, adept at prognosticating AVF outcomes from as early as post-operative day 2. In particular, a flow rate exceeding 246 ml/min and a cephalic vein diameter surpassing 3.4 mm are salient indicators for the early prediction of successful AVF outcomes.
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Affiliation(s)
- Shailendra K Chaudhary
- Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Arun Dikshit
- Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Neha Yadu
- Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anit Parihar
- Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Neera Kohli
- Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Durgesh Kumar Dwivedi
- Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
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12
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Mao J, Wang M, Wang C, Gu H, Meng X, Jiang Y, Yang X, Zhang J, Xiong Y, Zhao X, Liu L, Wang Y, Wang Y, Li Z, Zhu B. Glycated albumin levels are associated with adverse stroke outcomes in patients with acute ischemic stroke in China. J Diabetes 2024; 16:e13600. [PMID: 39264001 PMCID: PMC11391381 DOI: 10.1111/1753-0407.13600] [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: 01/10/2024] [Revised: 06/12/2024] [Accepted: 06/16/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND AND AIM Glycated albumin (GA) is a biomarker monitoring glycemia 2-4 weeks before stroke onset. This study was designed to explore the association between GA levels with poststroke outcomes in patients with acute ischemic stroke or transient ischemic attack (TIA). METHOD Participants with ischemic stroke or TIA who had a baseline GA measurement were included in the Third China National Stroke Registry study. The effect of GA on stroke recurrence, poor functional outcomes, and combined vascular events was examined during the 1-year follow-up period. Multivariate Cox and logistic regression models were performed to evaluate the association. Discrimination tests were used to examine the incremental predictive value of GA when incorporating it into the conventional model. RESULTS A total of 3861 participants were enrolled. At the 3-month follow-up, the elevated GA level was associated with an increased risk of poor functional outcomes (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.01-2.09). A similar increase was observed for stroke recurrence (adjusted hazard ratio [HR], 1.56; 95% CI, 1.09-2.24), poor functional outcomes (adjusted OR, 1.62; 95% CI, 1.07-2.45), and combined vascular events (adjusted HR, 1.55; 95% CI, 1.09-2.20) at the 1-year follow-up. In nondiabetic patients, the association between GA and poor functional outcomes was more pronounced (adjusted OR, 1.62; 95% CI, 1.05-2.50). Adding GA into the conventional model resulted in slight improvements in predicting poor functional outcomes (net reclassification improvement [NRI]: 12.30% at 1 year). CONCLUSION This study demonstrated that elevated GA levels in serum were associated with stroke adverse outcomes, including stroke recurrence, poor functional outcomes, and combined vascular events, in patients with ischemic stroke or TIA.
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Affiliation(s)
- Jiawen Mao
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Meng Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Chunjuan Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Hongqiu Gu
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Xia Meng
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Yong Jiang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Xin Yang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Jing Zhang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Yunyun Xiong
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Liping Liu
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- Research Unit of Artificial Intelligence in Cerebrovascular DiseaseChinese Academy of Medical SciencesBeijingChina
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- National Center for Healthcare Quality Management in Neurological DiseasesBeijing Tiantan HospitalBeijingChina
- Research Unit of Artificial Intelligence in Cerebrovascular DiseaseChinese Academy of Medical SciencesBeijingChina
| | - Bihong Zhu
- Department of NeurologyHuangyan Hospital of Wenzhou Medical UniversityZhejiangChina
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Chauhan A, Dubey S, Jain S. Association Between Type 2 Diabetes Mellitus and Alzheimer's Disease: Common Molecular Mechanism and Therapeutic Targets. Cell Biochem Funct 2024; 42:e4111. [PMID: 39228117 DOI: 10.1002/cbf.4111] [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: 06/12/2024] [Revised: 07/11/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Abstract
Diabetes mellitus (DM) and Alzheimer's disease (AD) rates are rising, mirroring the global trend of an aging population. Numerous epidemiological studies have shown that those with Type 2 diabetes (T2DM) have an increased risk of developing dementia. These degenerative and progressive diseases share some risk factors. To a large extent, the amyloid cascade is responsible for AD development. Neurofibrillary tangles induce neurodegeneration and brain atrophy; this chain reaction begins with hyperphosphorylation of tau proteins caused by progressive amyloid beta (Aβ) accumulation. In addition to these processes, it seems that alterations in brain glucose metabolism and insulin signalling lead to cell death and reduced synaptic plasticity in AD, before the onset of symptoms, which may be years away. Due to the substantial evidence linking insulin resistance in the brain with AD, researchers have coined the name "Type 3 diabetes" to characterize the condition. We still know little about the processes involved, even though current animal models have helped illuminate the links between T2DM and AD. This brief overview discusses insulin and IGF-1 signalling disorders and the primary molecular pathways that may connect them. The presence of GSK-3β in AD is intriguing. These proteins' association with T2DM and pancreatic β-cell failure suggests they might be therapeutic targets for both disorders.
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Affiliation(s)
- Aparna Chauhan
- Department of Pharmacy, School of Chemical Sciences and Pharmacy, Central University of Rajasthan, Rajasthan, India
| | - Sachin Dubey
- Department of Pharmacy, School of Chemical Sciences and Pharmacy, Central University of Rajasthan, Rajasthan, India
| | - Smita Jain
- Department of Pharmacy, School of Chemical Sciences and Pharmacy, Central University of Rajasthan, Rajasthan, India
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Deaver JE, Uchuya GM, Cohen WR, Foote JA. A retrospective cohort study of a community-based primary care program's effects on pharmacotherapy quality in low-income Peruvians with type 2 diabetes and hypertension. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003512. [PMID: 39173046 PMCID: PMC11341050 DOI: 10.1371/journal.pgph.0003512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 06/30/2024] [Indexed: 08/24/2024]
Abstract
Little is known about the effects of the Chronic Care Model (CCM) and community health workers (CHWs) on pharmacotherapy of type 2 diabetes and hypertension in resource-poor settings. This retrospective cohort implementation study evaluated the effects of a community-based program consisting of CCM, CHWs, guidelines-based treatment protocols, and inexpensive freely accessible medications on type 2 diabetes and hypertension pharmacotherapy quality. A door-to-door household survey identified 856 adults 35 years of age and older living in a low-income Peruvian community, of whom 83% participated in screening for diabetes and hypertension. Patients with confirmed type 2 diabetes and/or hypertension participated in the program's weekly to monthly visits for < = 27 months. The program was implemented as two care periods employed sequentially. During home care, CHWs made weekly home visits and a physician made treatment decisions remotely. During subsequent clinic care, a physician attended patients in a centralized clinic. The study compared the effects of program (pre- versus post-) (N = 262 observations), and home versus clinic care periods (N = 211 observations) on standards of treatment with hypoglycemic and antihypertensive agents, angiotensin converting enzyme inhibitors, and low-dose aspirin. During the program, 80% and 50% achieved hypoglycemic and antihypertensive standards, respectively, compared to 35% and 8% prior to the program, RRs 2.29 (1.72-3.04, p <0.001) and 6.64 (3.17-13.9, p<0.001). Achievement of treatment standards was not improved by clinic compared to home care (RRs 1.0 +/- 0.08). In both care periods, longer retention in care (>50% of allowable time) was associated with achievement of all treatment standards. 85% compared to 56% achieved the hypoglycemic treatment standard with longer and shorter retention, respectively, RR 1.52 (1.13-2.06, p<0.001); 56% compared to 27% achieved the antihypertensive standard, RR 2.11 (1.29-3.45, p<0.001). In a dose-dependent manner, the community-based program was associated with improved guidelines-based pharmacotherapy of type 2 diabetes and hypertension.
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Affiliation(s)
| | | | - Wayne R. Cohen
- College of Medicine, University of Arizona, Tucson, Arizona, United States of America
| | - Janet A. Foote
- College of Public Health, University of Arizona, Tucson, Arizona, United States of America
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15
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Shiri H, Fallah H, Abolhassani M, Fooladi S, Ramezani Karim Z, Danesh B, Abbasi-Jorjandi M. Relationship between types and levels of free fatty acids, peripheral insulin resistance, and oxidative stress in T2DM: A case-control study. PLoS One 2024; 19:e0306977. [PMID: 39133724 PMCID: PMC11318896 DOI: 10.1371/journal.pone.0306977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 06/25/2024] [Indexed: 08/15/2024] Open
Abstract
Free Fatty Acids (FFAs) are vital for energy homeostasis and the pathogenesis of a variety of diseases, including diabetes. For the first time, we presumed and investigated the types and levels of FFAs and their links to Insulin Resistance (IR) and Oxidative Stress (OS) in T2DM. A case-control study was conducted on 60 individuals with diabetes, 60 prediabetics with IFG, and 60 control groups. A Gas Chromatography Flame Ionization Detector (GC-FID) was used to estimate FFAs, which were then classified based on length and saturation. Indeed, antioxidant parameters such as TAC, MDA levels, PON-1, SOD-3, and CAT activity were assessed. Higher levels of LCFFA, SFFA, USFFA, and total FFA were found in people with diabetes and prediabetes. These levels were also linked to higher levels of HOMA-IR, BMI, FBS, HbA1C, and MDA, but lower levels of antioxidants. Furthermore, adjusting the above FFAs with age, sex, and antihypertensive medication increased T2DM development. SCFFA and ω3/6 fatty acids had a negative relationship with HOMA-IR, FBS, and insulin and a positive relationship with TAC. Adjusted SCFFA reduces T2DM risk. According to our models, total FFA is utilized to diagnose diabetes (AUC = 83.98, cut-off > 919 μM) and SCFFA for prediabetes (AUC = 82.32, cut-off < 39.56 μM). Total FFA (≥ 776 μM), LCFFA (≥ 613 μM), SFFA (≥ 471 μM), and USFFA (≥ 398 μM) all increase the risk of T2DM by increasing OS, BMI, and HOMA-IR. On the other hand, SCFFAs (≥ 38.7 μM) reduce the risk of T2DM by reducing BMI, HOMA-IR, and OS. SCFFAs and total FFAs can be used for the diagnosis of prediabetes and diabetes, respectively.
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Affiliation(s)
- Hamidreza Shiri
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fallah
- Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman, Iran
| | - Moslem Abolhassani
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Saba Fooladi
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Ramezani Karim
- Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Danesh
- Department of Internal Medicine, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mojtaba Abbasi-Jorjandi
- Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
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16
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Zhang Y, Meng F, Fei X, Wang K, Wu Y, Wang X. Association between physical activity level and diabetes incidence among Chinese middle-aged and older adults: a cross-sectional study from the China health and retirement longitudinal study. Front Public Health 2024; 12:1430229. [PMID: 39185125 PMCID: PMC11341424 DOI: 10.3389/fpubh.2024.1430229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 08/27/2024] Open
Abstract
Background It has been shown that diabetes is associated with insufficient physical activity among middle-aged and older adults, but the association between different physical activity levels (PAL) and diabetes incidence needs to be further explored. Objective This study aims to explore the correlation and dose-response relationship between different PAL and the diabetes incidence in middle-aged and older adults. Methods Utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), this cross-sectional analysis included 17,226 middle-aged and older adults aged 45 and above. Binary logistic regression models and restricted cubic spline (RCS) were used to explore the correlation and dose-response relationship between different PAL and the incidence of diabetes in the total middle-aged and older adults population as well as in subgroups. Sensitivity analyses were also performed to verify the robustness of the findings. Results In the entire study population, compared with the lowest PAL, participants in the third and fourth quartiles PAL saw diabetes incidence significantly reduced by 16% (p = 0.005) and 33% (p < 0.001), respectively (p for trend < 0.001). In subgroup analyses, the fourth quartile PAL significantly reduced the diabetes incidence among females, individuals aged 60-69, and rural residents by 25% (p = 0.011), 38% (p < 0.001) and 28% (p < 0.001), respectively. For males, middle-aged (45-59 years), and urban residents, the third quartile PAL reduced diabetes incidence by 22% (p = 0.004), 24% (p = 0.012), 21% (p = 0.013), respectively. When the fourth quartile PAL was reached, the diabetes incidence was significantly reduced in these populations by 41% (p < 0.001), 39% (p < 0.001), and 41% (p < 0.001), respectively. There was a negative dose-response relationship between physical activity and diabetes incidence in specific Chinese middle-aged and older adults population. In addition, sensitivity analyses indicated the robustness of the findings. Conclusion Higher PAL was associated with lower diabetes incidence in specific Chinese middle-aged and older adults population. It is feasible to use physical activity to predict diabetes incidence in this demographic, and high PAL may be an effective means of preventing and controlling diabetes.
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Affiliation(s)
- Yunqing Zhang
- China Basketball College, Beijing Sport University, Beijing, China
| | - Fanhao Meng
- School of Strength and Conditioning, Beijing Sport University, Beijing, China
| | - Xueyin Fei
- Sport Science School, Beijing Sport University, Beijing, China
| | - Ke Wang
- China Basketball College, Beijing Sport University, Beijing, China
| | - Yigao Wu
- China Institute of Sports and Health Science, Beijing Sport University, Beijing, China
| | - Xueting Wang
- Department of Physical Education, Jiangsu Normal University, Xuzhou, China
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17
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Wang Z, Haslam DE, Sawicki CM, Rivas-Tumanyan S, Hu FB, Liang L, Wong DTW, Joshipura KJ, Bhupathiraju SN. Saliva, Plasma, and Multifluid Metabolomic Signatures of Periodontal Disease, Type 2 Diabetes Progression, and Markers of Glycemia and Dyslipidemia Among Puerto Rican Adults With Overweight and Obesity. J Am Heart Assoc 2024; 13:e033350. [PMID: 39023061 DOI: 10.1161/jaha.123.033350] [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: 10/30/2023] [Accepted: 05/23/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Evidence from cohort studies indicates a bidirectional relationship between periodontal disease and type 2 diabetes (T2D), but the underlying mechanisms remain unknown. In this study, we aimed to (1) identify saliva, plasma, and multifluid metabolomic signatures associated with periodontal disease and (2) determine if these signatures predict T2D progression and cardiometabolic biomarkers at year 3. METHODS AND RESULTS We included participants from the SOALS (San Juan Overweight Adult Longitudinal Study) (n=911). Metabolites from saliva (k=635) and plasma (k=1051) were quantified using liquid chromatography-mass spectrometry. We applied elastic net regression with 10-fold cross-validation to identify baseline metabolomic signatures of periodontal disease. Multivariable Cox proportional hazards regression and linear regression were used to evaluate the association with T2D progression and biomarker concentrations. Metabolomic profiles included highly weighted metabolites related to lysine and pyrimidine metabolism. Periodontal disease or its 3 metabolomic signatures were not associated with T2D progression in 3 years. Prospectively, 1-SD increments in the multifluid and saliva metabolomic signatures were associated with higher low-density lipoprotein (multifluid: 12.9±5.70, P=0.02; saliva: 13.3±5.11, P=0.009). A 1-SD increment in the plasma metabolomic signature was also associated with Homeostatic Model Assessment for Insulin Resistance (2.67±1.14, P=0.02) and triglyceride (0.52±0.18, P=0.002). CONCLUSIONS Although metabolomic signatures of periodontal disease could not predict T2D progression, they were associated with low-density lipoprotein, triglyceride, and Homeostatic Model Assessment for Insulin Resistance levels at year 3.
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Affiliation(s)
- Zicheng Wang
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
| | - Danielle E Haslam
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA USA
- Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA USA
| | - Caleigh M Sawicki
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
- Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA USA
| | | | - Frank B Hu
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA USA
| | - Liming Liang
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
- Department of Biostatistics Harvard T.H. Chan School of Public Health Boston MA USA
| | - David T W Wong
- School of Dentistry University of California, Los Angeles Los Angeles CA USA
| | - Kaumudi J Joshipura
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
- Ahmedabad University School of Public Health Ahmedabad Gujarat India
| | - Shilpa N Bhupathiraju
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA USA
- Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA USA
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18
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Rivas-Tumanyan S, Pacheco LS, Haslam DE, Morou-Bermudez E, Liang L, Tucker KL, Joshipura KJ, Bhupathiraju SN. Branched-Chain and Aromatic Amino Acids, Type 2 Diabetes, and Cardiometabolic Risk Factors among Puerto Rican Adults. Nutrients 2024; 16:2562. [PMID: 39125441 PMCID: PMC11313859 DOI: 10.3390/nu16152562] [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: 06/20/2024] [Revised: 07/17/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
(1) Background: Branched-chain and aromatic amino acids (BCAAs/AAAs) have been considered as markers of type 2 diabetes (T2D); however, studies on associations between these metabolites and T2D and cardiometabolic traits in Hispanic populations are limited. The aim of this study was to examine the associations between baseline BCAAs (isoleucine, leucine, valine)/AAAs (phenylalanine, tyrosine) and prevalent and incident T2D, as well as baseline and longitudinal (2 year) changes in cardiometabolic traits (measures of glycemia, dyslipidemia, inflammation, and obesity) in two large cohorts of adults of Puerto Rican descent. (2) Methods: We included participants of the Boston Puerto Rican Health Study (BPRHS, n = 670) and San Juan Overweight Adult Longitudinal study (SOALS, n = 999) with available baseline metabolite and covariate data. T2D diagnosis was defined based on American Diabetes Association criteria. Multivariable logistic (for baseline T2D), Poisson (for incident T2D), and linear (for cardiometabolic traits) regression models were used; cohort-specific results were combined in the meta-analysis and adjusted for multiple comparisons. (3) Results: Higher baseline BCAAs were associated with higher odds of prevalent T2D (OR1SD BCAA score = 1.46, 95% CI: 1.34-1.59, p < 0.0001) and higher risk of incident T2D (IRR1SD BCAA score = 1.24, 95% CI: 1.13-1.37, p < 0.0001). In multivariable longitudinal analysis, higher leucine and valine concentrations were associated with 2-year increase in insulin (beta 1SD leucine = 0.37 mcU/mL, 95% CI: 0.11-0.63, p < 0.05; beta 1SD valine = 0.43 mcU/mL, 95% CI: 0.17-0.68, p < 0.01). Tyrosine was a significant predictor of incident T2D (IRR = 1.31, 95% CI: 1.09-1.58, p < 0.05), as well as 2 year increases in HOMA-IR (beta 1SD tyrosine = 0.13, 95% CI: 0.04-0.22, p < 0.05) and insulin concentrations (beta 1SD tyrosine = 0.37 mcU/mL, 95% CI: 0.12-0.61, p < 0.05). (4) Conclusions: Our results confirmed the associations between BCAAs and prevalent and incident T2D, as well as concurrent measures of glycemia, dyslipidemia, and obesity, previously reported in predominantly White and Asian populations. Baseline leucine, valine, and tyrosine were predictors of 2 year increases in insulin, whereas tyrosine was a significant predictor of deteriorating insulin resistance over time. Our study suggests that BCAAs and tyrosine could serve as early markers of future glycemic changes in Puerto Ricans.
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Affiliation(s)
- Sona Rivas-Tumanyan
- Department of Surgical Sciences and the Office of the Assistant Dean for Research, School of Dental Medicine, University of Puerto Rico, San Juan, PR 00936, USA; (S.R.-T.)
| | - Lorena S. Pacheco
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Danielle E. Haslam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA
| | - Evangelia Morou-Bermudez
- Department of Surgical Sciences and the Office of the Assistant Dean for Research, School of Dental Medicine, University of Puerto Rico, San Juan, PR 00936, USA; (S.R.-T.)
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts, Lowell, MA 01854, USA
| | - Kaumudi J. Joshipura
- Dean, School of Public Health, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India
| | - Shilpa N. Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA
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19
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Patel R, Marrie RA, Bernstein CN, Bolton JM, Graff LA, Marriott JJ, Figley CR, Kornelsen J, Mazerolle EL, Helmick C, Uddin MN, Fisk JD. Vascular Disease Is Associated With Differences in Brain Structure and Lower Cognitive Functioning in Inflammatory Bowel Disease: A Cross-Sectional Study. Inflamm Bowel Dis 2024; 30:1309-1318. [PMID: 37740523 PMCID: PMC11291614 DOI: 10.1093/ibd/izad204] [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: 02/17/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Vascular disease and cognitive impairment have been increasingly documented in inflammatory bowel disease (IBD), and both have been individually correlated with changes in brain structure. This study aimed to determine if both macro- and microstructural brain changes are prevalent in IBD and whether alterations in brain structure mediate the relationship between vascular disease and cognitive functioning. METHODS Eighty-four IBD participants underwent multimodal magnetic resonance imaging. Volumetric and mean diffusivity measures of the thalamus, hippocampus, normal-appearing white matter, and white matter lesions were converted to age- and sex-adjusted z scores. Vascular comorbidity was assessed using a modified Framingham Risk Score and cognition was assessed using a battery of neuropsychological tests. Test scores were standardized using local regression-based norms. We generated summary statistics for the magnetic resonance imaging metrics and cognitive tests, and these were examined using canonical correlation analysis and linear regression modeling. RESULTS Greater vascular comorbidity was negatively correlated with thalamic, normal-appearing white matter, and white matter lesion volumes. Higher Framingham Risk Score were also correlated with lower processing speed, learning and memory, and verbal fluency. Increased vascular comorbidity was predictive of poorer cognitive functioning, and this effect was almost entirely mediated (94.76%) by differences in brain structure. CONCLUSIONS Vascular comorbidity is associated with deleterious effects on brain structure and lower cognitive functioning in IBD. These findings suggest that proper identification and treatment of vascular disease is essential to the overall management of IBD, and that certain brain areas may serve as critical targets for predicting the response to therapeutic interventions.
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Affiliation(s)
- Ronak Patel
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - James M Bolton
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada
| | - Lesley A Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - James J Marriott
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Chase R Figley
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
- PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
- PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
| | - Erin L Mazerolle
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Carl Helmick
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Md Nasir Uddin
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA
| | - John D Fisk
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
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20
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Li B, Yang Z, Liu Y, Zhou X, Wang W, Gao Z, Yan L, Qin G, Tang X, Wan Q, Chen L, Luo Z, Ning G, Gu W, Mu Y. Clinical characteristics and complication risks in data-driven clusters among Chinese community diabetes populations. J Diabetes 2024; 16:e13596. [PMID: 39136497 PMCID: PMC11320751 DOI: 10.1111/1753-0407.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/23/2024] [Accepted: 06/02/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Novel diabetes phenotypes were proposed by the Europeans through cluster analysis, but Chinese community diabetes populations might exhibit different characteristics. This study aims to explore the clinical characteristics of novel diabetes subgroups under data-driven analysis in Chinese community diabetes populations. METHODS We used K-means cluster analysis in 6369 newly diagnosed diabetic patients from eight centers of the REACTION (Risk Evaluation of cAncers in Chinese diabeTic Individuals) study. The cluster analysis was performed based on age, body mass index, glycosylated hemoglobin, homeostatic modeled insulin resistance index, and homeostatic modeled pancreatic β-cell functionality index. The clinical features were evaluated with the analysis of variance (ANOVA) and chi-square test. Logistic regression analysis was done to compare chronic kidney disease and cardiovascular disease risks between subgroups. RESULTS Overall, 2063 (32.39%), 658 (10.33%), 1769 (27.78%), and 1879 (29.50%) populations were assigned to severe obesity-related and insulin-resistant diabetes (SOIRD), severe insulin-deficient diabetes (SIDD), mild age-associated diabetes mellitus (MARD), and mild insulin-deficient diabetes (MIDD) subgroups, respectively. Individuals in the MIDD subgroup had a low risk burden equivalent to prediabetes, but with reduced insulin secretion. Individuals in the SOIRD subgroup were obese, had insulin resistance, and a high prevalence of fatty liver, tumors, family history of diabetes, and tumors. Individuals in the SIDD subgroup had severe insulin deficiency, the poorest glycemic control, and the highest prevalence of dyslipidemia and diabetic nephropathy. Individuals in MARD subgroup were the oldest, had moderate metabolic dysregulation and the highest risk of cardiovascular disease. CONCLUSION The data-driven approach to differentiating the status of new-onset diabetes in the Chinese community was feasible. Patients in different clusters presented different characteristics and risks of complications.
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Affiliation(s)
- Binqi Li
- School of MedicineNankai UniversityTianjinChina
- Department of Endocrinologythe First medical center of PLA General HospitalBeijingChina
| | | | - Yang Liu
- Department of Endocrinologythe First medical center of PLA General HospitalBeijingChina
- Department of Endocrinologythe eighth medical center of PLA General HospitalBeijingChina
| | - Xin Zhou
- Graduate SchoolChinese PLA General HospitalBeijingChina
- Department of Medical Oncologythe Fifth Medical Center of Chinese PLA General HospitalBeijingChina
- Department of GeriatricsThe Second Medical Center of Chinese PLA General HospitalBeijingChina
| | - Weiqing Wang
- Department of Endocrinology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhengnan Gao
- Department of EndocrinologyDalian Central HospitalDalianChina
| | - Li Yan
- Department of EndocrinologyZhongshan University Sun Yat‐sen Memorial HospitalGuangzhouChina
| | - Guijun Qin
- Department of EndocrinologyFirst Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Xulei Tang
- Department of EndocrinologyFirst Hospital of Lanzhou UniversityLanzhouChina
| | - Qin Wan
- Department of EndocrinologySouthwest Medical University Affiliated HospitalLuzhouChina
| | - Lulu Chen
- Department of EndocrinologyWuhan Union Hospital, Huazhong University of Science and TechnologyWuhanChina
| | - Zuojie Luo
- Department of EndocrinologyFirst Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Guang Ning
- Department of Endocrinology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Weijun Gu
- Department of Endocrinologythe First medical center of PLA General HospitalBeijingChina
| | - Yiming Mu
- School of MedicineNankai UniversityTianjinChina
- Department of Endocrinologythe First medical center of PLA General HospitalBeijingChina
- Department of Endocrinologythe eighth medical center of PLA General HospitalBeijingChina
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21
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Xu G, Song J. The Association Between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and the Incidence of Type 2 Diabetes Mellitus in the Japanese Population. Metab Syndr Relat Disord 2024; 22:471-478. [PMID: 38593410 DOI: 10.1089/met.2023.0314] [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] [Indexed: 04/11/2024] Open
Abstract
Abstract Aims: To explore whether the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) was independently associated with the risk of incident type 2 diabetes mellitus (T2DM) in a large Japanese cohort. Methods: A secondary analysis was performed using open-access data from a retrospective cohort study. A total of 12,716 eligible participants who had standard medical examinations at the Murakami Memorial Hospital were included in this study. New-onset T2DM was the main outcome during follow-up. The risk of T2DM based on the TG/HDL-C ratio was evaluated using Cox regression analysis and Kaplan-Meier analysis. Subgroup analysis was performed to understand further the significance of the TG/HDL-C ratio in particular populations. To assess the potential of the TG/HDL-C ratio for predicting T2DM, a receiver operating characteristic (ROC) analysis was performed. Results: One hundred fifty new-onset T2DM cases were observed during a median follow-up of 5.39 years. The incidence of T2DM increased with a rise in the TG/HDL-C ratio based on the Kaplan-Meier curves (P < 0.0001). After controlling for potential confounding variables, the TG/HDL-C ratio was positively related to incidence of T2DM (hazard ratio = 1.08, 95% confidence interval: 1.01-1.15, P = 0.0239). In subgroup analysis, those with a body mass index of ≥18.5 and <24 kg/m2 showed a significantly positive relationship. The area under the ROC curve for the TG/HDL-C ratio as a T2DM predictor was 0.684. The optimal TG/HDL-C ratio cutoff value for T2DM was 1.609, with a sensitivity of 54.7% and a specificity of 73.6%. Conclusion: The authors' results showed a significant relationship between the TG/HDL-C ratio and the incidence of T2DM in the Japanese population.
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Affiliation(s)
- Guojuan Xu
- Department of Cardiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Song
- Department of Cardiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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22
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Li MZ, Guo T, Feng YL, Zhang SY, Bai XY, Wu X, Xu K, Yang AM. Diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy. Hepatobiliary Pancreat Dis Int 2024; 23:393-398. [PMID: 37121837 DOI: 10.1016/j.hbpd.2023.04.006] [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: 11/07/2022] [Accepted: 04/14/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND A high prevalence of diabetes mellitus (DM) coexisting with autoimmune pancreatitis (AIP) is observed. However, evidence on the circumstances under which corticosteroid therapy (CST) for AIP improves or worsens DM is scarce. This study aimed to demonstrate and identify predictors of DM control under the influence of CST. METHODS Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed: pre-existing DM (pDM), concurrent DM (cDM), and non-DM (nDM). The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as 'improvement' and 'non-improvement' (including 'no change' and 'exacerbation'). RESULTS Among 101 patients with type 1 AIP, 52 (51.5%) patients were complicated with DM at the time of AIP diagnosis, with 36 patients in the cDM group and 16 patients in the pDM group. The incidences of diffuse pancreatic swelling (72.2%) and pancreatic body/tail involvement (91.7%) were significantly higher in the cDM group than in both the pDM and nDM groups. Of the 52 patients with DM, CST was administered in 48 cases. Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase (GGT) level at AIP diagnosis [odds ratio (OR) = 0.032, 95% confidence interval (CI): 0.003-0.412, P = 0.008] and pancreatic atrophy after CST (OR = 0.027, 95% CI: 0.003-0.295, P = 0.003) were negatively associated with DM control improvement. CONCLUSIONS Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP diagnosis. CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis, particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.
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Affiliation(s)
- Mei-Zi Li
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Tao Guo
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yun-Lu Feng
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Sheng-Yu Zhang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiao-Yin Bai
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xi Wu
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Kai Xu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Ai-Ming Yang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
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23
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AlGhatrif M, Morrell CH, Fleg JL, Chantler PD, Najjar SS, Becker LC, Ferrucci L, Gerstenblith G, Lakatta EG. Longitudinal decline in peak V̇o 2 with aging in a healthy population is associated with a reduction in peripheral oxygen utilization but not in cardiac output. Am J Physiol Heart Circ Physiol 2024; 327:H509-H517. [PMID: 38874616 PMCID: PMC11442097 DOI: 10.1152/ajpheart.00665.2023] [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: 10/16/2023] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
Aging is associated with a significant decline in aerobic capacity assessed by maximal exercise oxygen consumption (V̇o2max). The relative contributions of the specific V̇o2 components driving this decline, namely cardiac output (CO) and arteriovenous oxygen difference (A - V)O2, remain unclear. We examined this issue by analyzing data from 99 community-dwelling participants (baseline age: 21-96 yr old; average follow-up: 12.6 yr old) from the Baltimore Longitudinal Study of Aging, free of clinical cardiovascular disease. V̇o2peak, a surrogate of V̇o2max, was used to assess aerobic capacity during upright cycle ergometry. Peak exercise left ventricular volumes, heart rate, and CO were estimated using repeated gated cardiac blood pool scans. The Fick equation was used to calculate (A - V)O2diff,peak from COpeak and V̇o2peak. In unadjusted models, V̇o2peak, (A - V)O2diff,peak, and COpeak declined longitudinally over time at steady rates with advancing age. In multiple linear regression models adjusting for baseline values and peak workload, however, steeper declines in V̇o2peak and (A - V)O2diff,peak were observed with advanced entry age but not in COpeak. The association between the declines in V̇o2peak and (A - V)O2diff,peak was stronger among those ≥50 yr old compared with their younger counterparts, but the difference between the two age groups did not reach statistical significance. These findings suggest that age-associated impairment of peripheral oxygen utilization during maximal exercise poses a stronger limitation on peak V̇o2 than that of CO. Future studies examining interventions targeting the structure and function of peripheral muscles and their vasculature to mitigate age-associated declines in (A - V)O2diff are warranted.NEW & NOTEWORTHY The age-associated decline in aerobic exercise performance over an average of 13 yr in community-dwelling healthy individuals is more closely associated with decreased peripheral oxygen utilization rather than decreased cardiac output. This association was more evident in older than younger individuals. These findings suggest that future studies with larger samples examine whether these associations vary across the age range and whether the decline in cardiac output plays a greater role earlier in life. In addition, studies focused on determinants of peripheral oxygen uptake by exercising muscle may guide the selection of preventive strategies designed to maintain physical fitness with advancing age.
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Affiliation(s)
- Majd AlGhatrif
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States
- Longitudinal Study Section, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Christopher H Morrell
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States
| | - Jerome L Fleg
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland, United States
| | - Paul D Chantler
- Department of Exercise Physiology, West Virginia University, Morgantown, West Virginia, United States
| | - Samer S Najjar
- Department of Cardiology, MedStar Heart and Vascular Institute, MedStar Health, Baltimore, Maryland, United States
| | - Lewis C Becker
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Luigi Ferrucci
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States
| | - Gary Gerstenblith
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States
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24
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Ledo Piñeiro A, Abu-Assi E, González Bermúdez I, Noriega Caro V, Íñiguez-Romo A, Raposeiras-Roubín S. Is pre-diabetes a predictor of events in patients with atrial fibrillation? Int J Cardiol 2024; 407:132086. [PMID: 38648915 DOI: 10.1016/j.ijcard.2024.132086] [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: 01/22/2024] [Revised: 04/14/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Diabetes mellitus (DM) increases the probability of presenting atrial fibrillation (AF) and it is a predictor of its ischemic stroke. There is limited information of the association between glycated hemoglobin (HbA1c) levels and ischemic, embolic or bleeding events in patients with pre-DM and AF. METHODS To investigate whether the presence of pre-DM in patients with AF predicts ischemic or bleeding events, myocardial infarction or mortality, we performed a retrospective study with a final cohort of 2993 non-diabetic patients with AF and data of glycated hemoglobin (HbA1c). We divided the cohort in two groups: those with normal glucose (n = 1351) and those with pre-diabetes (n = 1642). Incidence rates were calculated as the number of events per 100 person-years and were then compared between groups. Competitive hazard regression analysis for non-fatal events(death as the competing event) and conventional Cox regression for mortality were performed. RESULTS There was not difference between groups for incidence rates of the different events per 100 person-years. Even considering HbA1c as continuous variable, the unadjusted analysis showed no relation between levels of HbA1c and more risk of events. This association remained not significant after adjustment for CHA2DS2-VASc score, HAS-BLED score and anticoagulation therapy. CONCLUSION In this study of 2993 non-diabetic patients with new-onset AF, we have not found an association between HbA1c and worse prognosis when it is in the range of pre-diabetes.
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Affiliation(s)
- Ana Ledo Piñeiro
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain; Health Research Institute Galicia Sur, Vigo, Spain.
| | - Emad Abu-Assi
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain; Health Research Institute Galicia Sur, Vigo, Spain
| | | | | | - Andrés Íñiguez-Romo
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain; Health Research Institute Galicia Sur, Vigo, Spain
| | - Sergio Raposeiras-Roubín
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain; Health Research Institute Galicia Sur, Vigo, Spain; Health Sciences Department, Vigo University, Spain.
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25
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Cabral A, Carvalho A, Barros P, Ribeiro M, Castro S, Calvão-Pires P, Rodrigues M, Costa H, Battistella V, Gregório T, Paredes L, Veloso M, Rocha M. Glycemic variability after mechanical thrombectomy for anterior circulation acute ischemic stroke. Rev Neurol 2024; 79:1-9. [PMID: 38934944 PMCID: PMC11468031 DOI: 10.33588/rn.7901.2023356] [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: 05/04/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Morbidity remains high among patients who undergo successful mechanical thrombectomy (MT) for anterior circulation large vessel occlusion (LVO). Stress hyperglycemia worsens the prognosis after acute ischemic stroke (AIS), but aggressively treating hyperglycemia does not improve the outcome. There is no consensus on how to best manage glycemia after AIS. Glycemic variability (GV) reflects glycemic fluctuations over time and could be the culprit. We aimed to elucidate how GV impacts outcome of AIS patients treated with MT. PATIENTS AND METHODS This was a single-center retrospective study. We consecutively included AIS patients who received MT for anterior circulation LVO. We recorded discrete blood glucose measurements within the first 24 hours post thrombectomy, from which we calculated two measures of GV: standard deviation (SD) and coefficient of variation. Univariate and multivariate analyses were conducted to identify predictors of poor functional outcome (modified Ranking scale score 3-6) and mortality at 3-month follow-up. RESULTS We included 657 patients. Patients with poor functional outcome (42.5%) and patients that died (14.8%) had significantly higher GV as measured by SD. In a multivariable model adjusted for confounders, higher SD was associated with mortality -adjusted odds ratio: 1.020 (95% CI 1.001-1.040)- but not with functional outcome -adjusted odds ratio for modified Ranking scale score 3-6: 1.007 (95% CI 0.990-1.025)-. CONCLUSIONS Our results suggest that higher GV after MT for anterior circulation AIS is an independent risk factor for 3-month mortality. Future trials should evaluate the benefit of reducing GV in this setting.
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Affiliation(s)
- A Cabral
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Carvalho
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Barros
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Ribeiro
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Castro
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Calvão-Pires
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Rodrigues
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Costa
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - V Battistella
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - T Gregório
- Universidade do Porto, Porto, Portugal
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - L Paredes
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Veloso
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Rocha
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Schweickart A, Batra R, Neth BJ, Martino C, Shenhav L, Zhang AR, Shi P, Karu N, Huynh K, Meikle PJ, Schimmel L, Dilmore AH, Blennow K, Zetterberg H, Blach C, Dorrestein PC, Knight R, Craft S, Kaddurah-Daouk R, Krumsiek J. Serum and CSF metabolomics analysis shows Mediterranean Ketogenic Diet mitigates risk factors of Alzheimer's disease. NPJ METABOLIC HEALTH AND DISEASE 2024; 2:15. [PMID: 38962750 PMCID: PMC11216994 DOI: 10.1038/s44324-024-00016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/16/2024] [Indexed: 07/05/2024]
Abstract
Alzheimer's disease (AD) is influenced by a variety of modifiable risk factors, including a person's dietary habits. While the ketogenic diet (KD) holds promise in reducing metabolic risks and potentially affecting AD progression, only a few studies have explored KD's metabolic impact, especially on blood and cerebrospinal fluid (CSF). Our study involved participants at risk for AD, either cognitively normal or with mild cognitive impairment. The participants consumed both a modified Mediterranean Ketogenic Diet (MMKD) and the American Heart Association diet (AHAD) for 6 weeks each, separated by a 6-week washout period. We employed nuclear magnetic resonance (NMR)-based metabolomics to profile serum and CSF and metagenomics profiling on fecal samples. While the AHAD induced no notable metabolic changes, MMKD led to significant alterations in both serum and CSF. These changes included improved modifiable risk factors, like increased HDL-C and reduced BMI, reversed serum metabolic disturbances linked to AD such as a microbiome-mediated increase in valine levels, and a reduction in systemic inflammation. Additionally, the MMKD was linked to increased amino acid levels in the CSF, a breakdown of branched-chain amino acids (BCAAs), and decreased valine levels. Importantly, we observed a strong correlation between metabolic changes in the CSF and serum, suggesting a systemic regulation of metabolism. Our findings highlight that MMKD can improve AD-related risk factors, reverse some metabolic disturbances associated with AD, and align metabolic changes across the blood-CSF barrier.
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Affiliation(s)
- Annalise Schweickart
- Tri-Institutional Program in Computational Biology & Medicine, Weill Cornell Medicine, New York, NY USA
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY USA
| | - Richa Batra
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY USA
| | - Bryan J. Neth
- Department of Neurology, Mayo Clinic, Rochester, MN USA
| | - Cameron Martino
- Department of Pediatrics, University of California San Diego, La Jolla, CA USA
| | - Liat Shenhav
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY USA
| | - Anru R. Zhang
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC USA
| | - Pixu Shi
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC USA
| | - Naama Karu
- Tasmanian Independent Metabolomics and Analytical Chemistry Solutions (TIMACS), Hobart, TAS Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC Australia
- Baker Department of Cardiovascular Research Translation and Implementation, La Trobe University, Bundoora, VIC Australia
| | - Peter J. Meikle
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC Australia
- Baker Department of Cardiovascular Research Translation and Implementation, La Trobe University, Bundoora, VIC Australia
| | - Leyla Schimmel
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Colette Blach
- Duke Molecular Physiology Institute, Duke University, Durham, NC USA
| | - Pieter C. Dorrestein
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA USA
| | - Rob Knight
- Departments of Pediatrics, Computer Science and Engineering, Bioengineering, University of California San Diego, La Jolla, CA USA
| | - Alzheimer’s Gut Microbiome Project Consortium
- Tri-Institutional Program in Computational Biology & Medicine, Weill Cornell Medicine, New York, NY USA
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY USA
- Department of Neurology, Mayo Clinic, Rochester, MN USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA USA
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC USA
- Tasmanian Independent Metabolomics and Analytical Chemistry Solutions (TIMACS), Hobart, TAS Australia
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC Australia
- Baker Department of Cardiovascular Research Translation and Implementation, La Trobe University, Bundoora, VIC Australia
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
- Duke Molecular Physiology Institute, Duke University, Durham, NC USA
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA USA
- Departments of Pediatrics, Computer Science and Engineering, Bioengineering, University of California San Diego, La Jolla, CA USA
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, NC USA
- Duke Institute of Brain Sciences, Duke University, Durham, NC USA
- Department of Medicine, Duke University, Durham, NC USA
| | - Suzanne Craft
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, NC USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA
- Duke Institute of Brain Sciences, Duke University, Durham, NC USA
- Department of Medicine, Duke University, Durham, NC USA
| | - Jan Krumsiek
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY USA
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Zhou L, Dong M, Feng G, Zhang Y, Wang J, Kang H, Dong Z, Ning J, Zhao Z, Wang C. Semaglutide mitigates testicular damage in diabetes by inhibiting ferroptosis. Biochem Biophys Res Commun 2024; 715:149996. [PMID: 38678781 DOI: 10.1016/j.bbrc.2024.149996] [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: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Diabetes is linked to male infertility, but the mechanisms and therapeutic options remain unclear. This study investigates the effects of semaglutide on testicular function in a diabetes mouse model. Clinical data shows that diabetes affects blood glucose, lipid levels, and sperm quality. Single-cell and transcriptome analyses reveal changes in testicular tissue cell proportions and activation of ferroptosis pathways in diabetic patients/rats. In the diabetes mouse model, sperm quality decreases significantly. Treatment with semaglutide (Sem) and the ferroptosis inhibitor ferrostatin-1 (Fer-1) alleviates testicular damage, as evidenced by improved lipid peroxidation and ferroptosis markers. Moreover, the diabetes-induced decrease in the TM-3 cell line's vitality, increased lipid peroxidation, ROS, ferrous ions, and mitochondrial membrane potential damage are all improved by semaglutide and ferrostatin-1 intervention. Overall, these findings highlight semaglutide's potential as a therapeutic approach for mitigating diabetes-induced testicular damage through modulation of the ferroptosis pathway.
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Affiliation(s)
- Liang Zhou
- Department of Pharmacology, The Key Laboratory of Neural and Vascular Biology, Ministry of Education, The Key Laboratory of New Drug Pharmacology and Toxicology, The Hebei Collaboration Innovation Center for Mechanism, Diagnosis and Treatment of Neurological and Psychiatric Disease, Hebei Medical University, Shijiazhuang, 050017, China; Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, 050017, China
| | - Mei Dong
- Department of General Practice, The Affiliated Hospital of Hebei University of Science and Technology, Shijiazhuang, 050018, China
| | - Ge Feng
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, China
| | - Yiyi Zhang
- Department of Pharmacology, The Key Laboratory of Neural and Vascular Biology, Ministry of Education, The Key Laboratory of New Drug Pharmacology and Toxicology, The Hebei Collaboration Innovation Center for Mechanism, Diagnosis and Treatment of Neurological and Psychiatric Disease, Hebei Medical University, Shijiazhuang, 050017, China
| | - Jiaqi Wang
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, China
| | - Hening Kang
- College of Basic Medicine, Hebei Medical University, Shijiazhuang, 050017, China
| | - Zishan Dong
- Department of Pharmacology, The Key Laboratory of Neural and Vascular Biology, Ministry of Education, The Key Laboratory of New Drug Pharmacology and Toxicology, The Hebei Collaboration Innovation Center for Mechanism, Diagnosis and Treatment of Neurological and Psychiatric Disease, Hebei Medical University, Shijiazhuang, 050017, China
| | - Jingyuan Ning
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, China
| | - Zhiming Zhao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, 050017, China
| | - Chuan Wang
- Department of Pharmacology, The Key Laboratory of Neural and Vascular Biology, Ministry of Education, The Key Laboratory of New Drug Pharmacology and Toxicology, The Hebei Collaboration Innovation Center for Mechanism, Diagnosis and Treatment of Neurological and Psychiatric Disease, Hebei Medical University, Shijiazhuang, 050017, China.
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Topkaya MS, Akın O, Cömert TK. Does metabolic control of the disease related with bone turnover markers in children with type 1 diabetes mellitus in Turkey? BMC Endocr Disord 2024; 24:89. [PMID: 38872156 DOI: 10.1186/s12902-024-01553-0] [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: 09/18/2023] [Accepted: 02/06/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND The aim was to evaluate the effect of metabolic control on bone biomarkers in children with type I diabetes. MATERIALS AND METHODS The children were divided into two groups according to their glycated hemoglobin (HbA1c) (%) levels: a group with HbA1c levels < 8% (n = 16) and: a group with HbA1c levels > 8% (n = 18). The serum total oxidative status (TOS) (µmol/L), total antioxidant status (TAS) (mmol/L), alkaline phosphatase (ALP) (IU/L), osteocalcin (OC) (ng/ml), procollagen type-1-N-terminal peptide (P1NP) (ng/ml), and vitamin D (IU) levels and food consumption frequencies were determined. RESULTS When patients were classified according to HbA1c (%) levels, those with HbA1c levels < 8% were found to have lower TOS (µmol/L) values (8.7 ± 6.16, 9.5 ± 5.60) and higher serum OC (ng/mL) (24.2 ± 16.92, 22.0 ± 6.21) levels than those with HbA1c levels > 8% (p < 0.05). Regardless of the level of metabolic control, there was a statistically significant association between serum TOS (µmol/L) and P1NP (ng/ml) (p < 0.05) levels, with no group-specific relationship (HbA1c levels <%8 or HbA1c levels >%8). CONCLUSION HbA1c and serum TOS levels had an effect on bone turnover biomarkers in individuals with type I diabetes.
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Affiliation(s)
- Merve Sena Topkaya
- Department of Nutrition and Dietetics, Gülhane Health Sciences Institute, Health Sciences University, Ankara, Turkey
| | - Onur Akın
- Specialist of Pediatric Endocrinology, Department of Pediatric Endocrinology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Tuğba Küçükkasap Cömert
- Department of Nutrition and Dietetics, Gülhane Health Sciences Institute, Health Sciences University, Ankara, Turkey.
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Van Syoc E, Nixon MP, Silverman JD, Luo Y, Gonzalez FJ, Elbere I, Klovins J, Patterson AD, Rogers CJ, Ganda E. Changes in the type 2 diabetes gut mycobiome associate with metformin treatment across populations. mBio 2024; 15:e0016924. [PMID: 38767350 PMCID: PMC11237675 DOI: 10.1128/mbio.00169-24] [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: 01/18/2024] [Accepted: 04/08/2024] [Indexed: 05/22/2024] Open
Abstract
The human gut teems with a diverse ecosystem of microbes, yet non-bacterial portions of that community are overlooked in studies of metabolic diseases firmly linked to gut bacteria. Type 2 diabetes mellitus (T2D) is associated with compositional shifts in the gut bacterial microbiome and the mycobiome, the fungal portion of the microbiome. However, whether T2D and/or metformin treatment underpins fungal community changes is unresolved. To differentiate these effects, we curated a gut mycobiome cohort spanning 1,000 human samples across five countries and validated our findings in a murine experimental model. We use Bayesian multinomial logistic normal models to show that T2D and metformin both associate with shifts in the relative abundance of distinct gut fungi. T2D is associated with shifts in the Saccharomycetes and Sordariomycetes fungal classes, while the genera Fusarium and Tetrapisipora most consistently associate with metformin treatment. We confirmed the impact of metformin on individual gut fungi by administering metformin to healthy mice. Thus, metformin and T2D account for subtle, but significant and distinct variation in the gut mycobiome across human populations. This work highlights for the first time that metformin can confound associations of gut fungi with T2D and warrants the need to consider pharmaceutical interventions in investigations of linkages between metabolic diseases and gut microbial inhabitants. IMPORTANCE This is the largest to-date multi-country cohort characterizing the human gut mycobiome, and the first to investigate potential perturbations in gut fungi from oral pharmaceutical treatment. We demonstrate the reproducible effects of metformin treatment on the human and murine gut mycobiome and highlight a need to consider metformin as a confounding factor in investigations between type 2 diabetes mellitus and the gut microbial ecosystem.
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Affiliation(s)
- Emily Van Syoc
- Department of Biology, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michelle Pistner Nixon
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Justin D. Silverman
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Statistics, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Yuhong Luo
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Frank J. Gonzalez
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ilze Elbere
- Latvian Biomedical Research and Study Center, Riga, Latvia
| | - Janis Klovins
- Latvian Biomedical Research and Study Center, Riga, Latvia
| | - Andrew D. Patterson
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Connie J. Rogers
- Department of Nutritional Sciences, University of Georgia, Athens, Georgia, USA
| | - Erika Ganda
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
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Ambaye AS, Mengiste FY, Demise N, Derseh MT, Abebe A, Yayehrad AT, Endalifer BL. Prevalence of Hypoglycemia and Its Determinants Among Diabetes Patients on Insulin Treatment at Tepi General Hospital, Southwest, Ethiopia. Patient Prefer Adherence 2024; 18:1151-1161. [PMID: 38868670 PMCID: PMC11168415 DOI: 10.2147/ppa.s458091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024] Open
Abstract
Background Hypoglycemia occurs when the blood sugar levels are too low. In severe cases, hypoglycemia may give to seizures, coma, and sometimes death. The prevalence of hypoglycemia among patients with diabetes is likely underreported and undocumented. Methods An institutional-based cross-sectional study was conducted among 336 study participants at the Tepi General Hospital in Southwest Ethiopia. A binary logistic regression model was used to determine the association between the prevalence of hypoglycemia and the factors associated with it. After a bivariate analysis, variables with a p value of < 0.25 were selected as a candidate for multivariable analysis. An odds ratio with a 95% CI was considered to indicate a significant association. Results With 95% CI (52.48-62.25) the prevalence of hypoglycemia was determined as 57.44%. Nearly 11% of the patients encounter severe hypoglycemia. Female patients had three times higher odds of experiencing hypoglycemia (aOR=3, 95% CI: 2.10, 6.39). Those with no formal education had 1.5 times higher odds of experiencing hypoglycemia (aOR = 1.5, 95% CI: 1.08, 5.45). Patients with type 1 diabetes were 3.4 times more likely to experience hypoglycemia (aOR = 3.4, 95% CI: 1.87, 7.50). Those who had been diagnosed before 10 years (aOR = 1.3, 95% CI: 1.02, 3.21) were more likely to have hypoglycemia. Furthermore, patients who consumed alcohol were 3.0 times more likely to have a history of hypoglycemia (aOR = 3.0, 95% CI: 2.03, 6.43). Conclusion The magnitude of hypoglycemia among patients with diabetes is determined to be considerable with more than half of the participants encountered hypoglycemia. There is a strong relationship between the occurrence of hypoglycemia and sex, type of diabetes, time since diagnosis, alcohol status, and education status. Therefore, all concerned parties must pay close attention to lessen the prevalence of hypoglycemia and address the problems based on the primary contributing factors.
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Affiliation(s)
- Abyou Seyfu Ambaye
- Departement of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fiseha Yirgu Mengiste
- Departement of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Netsanet Demise
- Departement of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Manaye Tamrie Derseh
- Departement of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abinet Abebe
- Departement of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | | | - Bedilu Linger Endalifer
- Departement of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
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Secen EI, Desdicioglu R, Ergun GT, Usta E, Ozgu-Erdinc AS. The Relationship between a High Carbohydrate Diet and Oral Glucose Tolerance Test in Pregnancy. Z Geburtshilfe Neonatol 2024; 228:255-259. [PMID: 37591288 DOI: 10.1055/a-2143-8221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE The aim of this study is to examine the impact of carbohydrate ratios in the diet consumed one day prior to the 75-g oral glucose screening test on both the screening test values and the diagnosis of gestational diabetes mellitus in the unselective pregnant population. MATERIAL-METHOD 83 pregnant women who were under observation in the antenatal clinic of our hospital and underwent glucose tolerance tests were included in the study. The patients were given training by a dietitian to keep nutrition records of the day prior to glucose loading during their previous visits before any glucose loading. A carbohydrate intake of 40-60% was considered as the normal range in terms of the percentage of carbohydrates in the diet. A carbohydrate percentage above 60% was considered to be a high carbohydrate intake. The carbohydrate percentages in their diet over the past 24 hours was compared with the effect on the glucose tolerance test. RESULTS Out of the 83 pregnant women included in the study, 40 of them had a high carbohydrate diet (HCD) prior to the oral glucose tolerance test (OGTT), and the average carbohydrate percentage of this diet was found to be 62%. The remaining 43 patients had an average carbohydrate percentage of 49% and belonged to the group that had a normal carbohydrate diet (NCD). Out of the 83 pregnant women, 33 of them were at high risk for gestational diabetes mellitus (GDM). In the high-risk patient group, 16 patients had an NCD intake, while 17 patients had a HCD intake. It was determined that a high carbohydrate diet had no significant effect on fasting, first-hour, and second-hour glucose levels, as well as the diagnosis of gestational diabetes mellitus (GDM), in both the unselective population and the high-risk patient population. CONCLUSION In our study, we concluded that the high carbohydrate ratios in the diets of pregnant women one day prior did not affect the OGTT results or the GDM ratios. This indicates that there is no need for a preparatory diet prior to the OGTT in women with normal dietary habits.
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Affiliation(s)
- Elcin Islek Secen
- Department of Obstetrics and Gynecology, Ankara Yildirim Beyazit Universitesi, Ankara, Turkey
| | - Raziye Desdicioglu
- Department of Obstetrics and Gynecology, Ankara Yildirim Beyazit Universitesi, Ankara, Turkey
| | - Gonca Turker Ergun
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Esin Usta
- Dietetic and Nutrititon, Baskent University, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Sikhayeva N, Bolatov A, Zholdybayeva E, Akhmetollayev I, Iskakova A. Association of ADIPOQ Gene Polymorphisms with Type 2 Diabetes and Obesity Risk in the Kazakh Population: A Case-Control and Population-Based Study. Genes (Basel) 2024; 15:669. [PMID: 38927605 PMCID: PMC11203345 DOI: 10.3390/genes15060669] [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: 04/12/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a socially significant disease with increasing prevalence worldwide. It is characterized by heterogeneous metabolic disorders and is associated with various risk factors, including BMI, abnormal lipid levels, hypertension, smoking, dietary preferences, physical inactivity, sedentary lifestyle, family history of diabetes, prediabetes or gestational diabetes, inflammation, intrauterine environment, age, sex, ethnicity, and socioeconomic status. Assessing the genetic risk of developing T2DM in specific populations remains relevant. The ADIPOQ gene, encoding adiponectin, is directly related to the risk of developing T2DM, obesity, and cardiovascular diseases. Our study demonstrated significant associations of ADIPOQ gene polymorphisms with the risk of developing T2DM and obesity, as well as with fasting glucose levels and BMI, in the Kazakh population. Specifically, rs266729 was significantly associated with T2DM and obesity in the Kazakh population, while other studied polymorphisms (rs1501299, rs2241766, and rs17846866) did not show a significant association. These findings suggest that ADIPOQ gene polymorphisms may influence T2DM risk factors and highlight the importance of genetic factors in T2DM development. However, further research in larger cohorts is needed to confirm these associations.
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Affiliation(s)
- Nurgul Sikhayeva
- “National Center for Biotechnology” LLP, JSC National Holding “Qazbiopharm”, Korgalzhyn 13/1, Astana 010000, Kazakhstan; (E.Z.); (I.A.); (A.I.)
| | - Aidos Bolatov
- School of Medicine, Astana Medical University, Beibitshilik 49a, Astana 010000, Kazakhstan;
- Shenzhen University Medical School, Shenzhen University, 3688 Nanhai Road, Shenzhen 518060, China
| | - Elena Zholdybayeva
- “National Center for Biotechnology” LLP, JSC National Holding “Qazbiopharm”, Korgalzhyn 13/1, Astana 010000, Kazakhstan; (E.Z.); (I.A.); (A.I.)
| | - Ilyas Akhmetollayev
- “National Center for Biotechnology” LLP, JSC National Holding “Qazbiopharm”, Korgalzhyn 13/1, Astana 010000, Kazakhstan; (E.Z.); (I.A.); (A.I.)
| | - Aisha Iskakova
- “National Center for Biotechnology” LLP, JSC National Holding “Qazbiopharm”, Korgalzhyn 13/1, Astana 010000, Kazakhstan; (E.Z.); (I.A.); (A.I.)
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Tan MY, Weng L, Yang ZH, Zhu SX, Wu S, Su JH. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with type 2 diabetes mellitus: recent findings from NHANES 2007-2018. Lipids Health Dis 2024; 23:151. [PMID: 38773578 PMCID: PMC11106869 DOI: 10.1186/s12944-024-02143-8] [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: 03/14/2024] [Accepted: 05/11/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE This study aims to assess the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio) and Type 2 diabetes mellitus (T2DM) in US adults, using National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2018. METHODS This study explored the connection between NHHR and T2DM by analyzing a sample reflecting the adult population of the United States (n = 10,420; NHANES 2007-2018). NHHR was characterized as the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol. T2DM was defined based on clinical guidelines. This research used multivariable logistic models to examine the connection between NHHR and T2DM. Additionally, it included subgroup and interaction analyses to assess variations among different groups. Generalized additive models, smooth curve fitting, and threshold effect analysis were also employed to analyze the data further. RESULTS The study included 10,420 subjects, with 2160 diagnosed with T2DM and 8260 without. The weighted multivariate logistic regression model indicated an 8% higher probability of T2DM for each unit increase in NHHR (OR: 1.08, 95% CI: 1.01-1.15) after accounting for all covariates. Subgroup analysis outcomes were uniform across various categories, demonstrating a significant positive relationship between NHHR and T2DM. Interaction tests showed that the positive link between NHHR and T2DM remained consistent regardless of age, body mass index, smoking status, moderate recreational activities, hypertension, or stroke history, with all interaction P-values exceeding 0.05. However, participants' sex appeared to affect the magnitude of the connection between NHHR and T2DM (interaction P-value < 0.05). Also, a nonlinear association between NHHR and T2DM was discovered, featuring an inflection point at 1.50. CONCLUSIONS Our study suggests that an increase in NHHR may be correlated with a heightened likelihood of developing T2DM. Consequently, NHHR could potentially serve as a marker for estimating the probability of T2DM development.
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Affiliation(s)
- Mo-Yao Tan
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Li Weng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong-Hao Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Si-Xuan Zhu
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shan Wu
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jun-Hua Su
- Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China.
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Lu S, Wang Q, Lu H, Kuang M, Zhang M, Sheng G, Zou Y, Peng X. Lipids as potential mediators linking body mass index to diabetes: evidence from a mediation analysis based on the NAGALA cohort. BMC Endocr Disord 2024; 24:66. [PMID: 38730299 PMCID: PMC11083816 DOI: 10.1186/s12902-024-01594-5] [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: 03/06/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Body mass index (BMI) and lipid disorders are both known to be strongly associated with the development of diabetes, however, the indirect effect of lipid parameters in the BMI-related diabetes risk is currently unknown. This study aimed to investigate the mediating role of lipid parameters in the association of BMI with diabetes risk. METHODS We assessed the association of diabetes risk with BMI, as well as lipid parameters including high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-CF and LDL-CS), triglycerides(TG), total cholesterol(TC), remnant cholesterol(RC), non-HDL-C, and combined indices of lipid parameters with HDL-C (RC/HDL-C ratio, TG/HDL-C ratio, TC/HDL-C ratio, non-HDL/HDL-C ratio, LDL/HDL-C ratio) using data from 15,453 subjects in the NAGALA project. Mediation models were used to explore the mediating role of lipid parameters in the association of BMI with diabetes risk, and mediation percentages were calculated for quantifying the strength of the indirect effects. Finally, receiver operating characteristic curve (ROC) analysis was used to compare the accuracy of BMI and BMI combined with lipid parameters in predicting incident diabetes. RESULTS Multivariate regression models, adjusted for confounding factors, demonstrated robust associations of lipid parameters, BMI, with diabetes risk, with the exception of TC, LDL-CF, LDL-CS, and non-HDL-C. Mediation analysis showed that lipid parameters except TC, LDL-CF, LDL-CS, and Non-HDL-C were involved in and mediated the association of BMI with diabetes risk, with the largest mediation percentage being the RC/HDL-C ratio, which was as high as 40%; it is worth mentioning that HDL-C and HDL-C-related lipid ratio parameters also play an important mediating role in the association between BMI and diabetes, with the mediator proportion being greater than 30%. Finally, based on the ROC results, we found that the prediction performance of all lipid parameters in the current study except TC was significantly improved when combined with BMI. CONCLUSION Our fresh findings suggested that lipid parameters partially mediated the association of BMI with diabetes risk; this result indicated that in the context of diabetes risk screening and disease management, it is important to not only monitor BMI but also pay attention to lipid parameters, particularly HDL-C and HDL-C-related lipid ratio parameters.
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Affiliation(s)
- Song Lu
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Qun Wang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Hengcheng Lu
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Maobin Kuang
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Min Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Hypertension Research Institute, Nanchang, 330006, China
| | - Guotai Sheng
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China.
| | - Xiaoping Peng
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
- Jiangxi Hypertension Research Institute, Nanchang, 330006, China.
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Li B, Zhou X, Liu Y, Zhang Y, Mu Y. Remnant Cholesterol is More Strongly Associated with Arterial Stiffness than Traditional Lipids and Lipid Ratios in the General Chinese Population. J Atheroscler Thromb 2024; 31:587-602. [PMID: 38171806 PMCID: PMC11079499 DOI: 10.5551/jat.64146] [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: 12/27/2022] [Accepted: 10/22/2023] [Indexed: 01/05/2024] Open
Abstract
AIM Studies on the relationship between remnant cholesterol (RC) and arterial stiffness (AS) are limited. This study aims to investigate the relationship between RC and AS and to explore RC, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), non-HDL-C, LDL-C/HDL-C, TG/HDL-C, lipoprotein combine index (LCI), and TC/HDL-C, which are lipid parameters most strongly associated with AS. METHODS A total of 4653 participants from the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals) study were recruited. AS was defined as a brachial-ankle pulse wave velocity of ≥ 1400 cm/s. Multiple logistic regression analyses were performed to detect its association with lipid parameters (RC, TG, TC, HDL-C, LDL-C, non-HDL-C, LDL-C/HDL-C, TG/HDL-C, LCI, and TC/HDL-C). RESULTS Logistic regression analysis showed that compared with other traditional or non-traditional lipid parameters, the association between RC and AS was the strongest (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.30-1.95, P<0.001). In the stratified analysis, RC was significantly associated with AS in both sexes and at any age, as well as blood glucose, blood pressure, and body mass index levels. Besides, RC and AS were still significantly associated when TG<1.7 mmol/L (OR:1.58, 95% CI: 1.02-2.45, P=0.04), LDL-C <3.4 mmol/L (OR:1.32, 95% CI: 1.01-1.73, P=0.041), HDL-C ≥ 1.0 mmol/L (OR:1.67, 95% CI: 1.34-2.08, P<0.001), or non-HDL-C<4.1 mmol/L (OR: 1.42, 95% CI: 1.10-1.82, P=0.007) are controlled within the appropriate range. CONCLUSION In conclusion, compared with traditional lipids and lipid ratios, RC is more strongly associated with AS. The association between RC and AS remains significant even when TG, LDL-C, HDL-C, or non-HDL-C levels are controlled within the appropriate range.
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Affiliation(s)
- Binqi Li
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
| | - Xin Zhou
- Graduate School, Chinese PLA General Hospital, Beijing, China
- Department of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China>
- The Second Medical Center of Chinese PLA General Hospital, Beijing, China>
| | - Yang Liu
- Department of Endocrinology, Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Yue Zhang
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
| | - Yiming Mu
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
- Graduate School, Chinese PLA General Hospital, Beijing, China
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Lin W. The Association between Body Mass Index and Glycohemoglobin (HbA1c) in the US Population's Diabetes Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:517. [PMID: 38791732 PMCID: PMC11121031 DOI: 10.3390/ijerph21050517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/19/2024] [Accepted: 04/19/2024] [Indexed: 05/26/2024]
Abstract
Obesity, indicated by Body Mass Index (BMI), is a risk factor for type 2 diabetes. However, its association with glycated hemoglobin (HbA1c), a crucial indicator of blood-sugar control, may vary across different populations and disease statuses. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were analyzed. Participants aged 18-79 years with complete information on BMI, diabetes status, and HbA1c were included (n = 4003). Linear regression models were used to assess the association between BMI and HbA1c, adjusting for demographic confounders, smoking status, alcohol consumption, and healthcare access. Among participants without diabetes, BMI was positively associated with HbA1c levels (coefficient: 0.015, 95% CI: 0.01, 0.02; p-value < 0.05), after adjusting for potential confounders. However, this association was not significant among those with diabetes (coefficient: -0.005, 95% CI: -0.05, 0.04; p-value > 0.1). Our findings suggest a differential relationship between BMI and HbA1c in individuals with and without diabetes. While BMI remains a significant predictor of HbA1c in non-diabetic individuals, its significance diminishes in those with diabetes.
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Affiliation(s)
- Wenxue Lin
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA 19122, USA
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Klos L, Stratton G, Mackintosh KA, McNarry MA, Fogelholm M, Drummen M, Macdonald I, Martinez JA, Navas-Carretero S, Handjieva-Darlenska T, Bogdanov G, Gant N, Poppitt SD, Silvestre MP, Brand-Miller J, Muirhead R, Schlicht W, Huttunen-Lenz M, Brodie S, Jalo E, Westerterp-Plantenga M, Adam T, Siig Vestentoft P, Tikkanen H, Quist JS, Raben A, Swindell N. Combining diaries and accelerometers to explain change in physical activity during a lifestyle intervention for adults with pre-diabetes: A PREVIEW sub-study. PLoS One 2024; 19:e0300646. [PMID: 38512828 PMCID: PMC10956823 DOI: 10.1371/journal.pone.0300646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
Self-report and device-based measures of physical activity (PA) both have unique strengths and limitations; combining these measures should provide complementary and comprehensive insights to PA behaviours. Therefore, we aim to 1) identify PA clusters and clusters of change in PA based on self-reported daily activities and 2) assess differences in device-based PA between clusters in a lifestyle intervention, the PREVIEW diabetes prevention study. In total, 232 participants with overweight and prediabetes (147 women; 55.9 ± 9.5yrs; BMI ≥25 kg·m-2; impaired fasting glucose and/or impaired glucose tolerance) were clustered using a partitioning around medoids algorithm based on self-reported daily activities before a lifestyle intervention and their changes after 6 and 12 months. Device-assessed PA levels (PAL), sedentary time (SED), light PA (LPA), and moderate-to-vigorous PA (MVPA) were assessed using ActiSleep+ accelerometers and compared between clusters using (multivariate) analyses of covariance. At baseline, the self-reported "walking and housework" cluster had significantly higher PAL, MVPA and LPA, and less SED than the "inactive" cluster. LPA was higher only among the "cycling" cluster. There was no difference in the device-based measures between the "social-sports" and "inactive" clusters. Looking at the changes after 6 months, the "increased walking" cluster showed the greatest increase in PAL while the "increased cycling" cluster accumulated the highest amount of LPA. The "increased housework" and "increased supervised sports" reported least favourable changes in device-based PA. After 12 months, there was only minor change in activities between the "increased walking and cycling", "no change" and "increased supervised sports" clusters, with no significant differences in device-based measures. Combining self-report and device-based measures provides better insights into the behaviours that change during an intervention. Walking and cycling may be suitable activities to increase PA in adults with prediabetes.
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Affiliation(s)
- Leon Klos
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, Wales, United Kingdom
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, Wales, United Kingdom
| | - Kelly A. Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, Wales, United Kingdom
| | - Melitta A. McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, Wales, United Kingdom
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Ian Macdonald
- School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - J. Alfredo Martinez
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
- CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Program for Precision Nutrition, IMDEA Food Institute, Madrid, Spain
| | - Santiago Navas-Carretero
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
- CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Georgi Bogdanov
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Nicholas Gant
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Sally D. Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Marta P. Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- Centro de Investigaçao em Tecnologias e Serciços de Saûde (CINTESIS), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Jennie Brand-Miller
- School of Life and Environmental Biosciences and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Biosciences and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | | | - Shannon Brodie
- School of Life and Environmental Biosciences and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Tanja Adam
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Heikki Tikkanen
- Faculty of Health Sciences School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jonas S. Quist
- Department for Clinical and Translational Research, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Department for Clinical and Translational Research, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Nils Swindell
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, Wales, United Kingdom
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Li X, Cai QY, Luo X, Wang YH, Shao LZ, Luo SJ, Wang L, Wang YX, Lan X, Liu TH. Gestational diabetes mellitus aggravates adverse perinatal outcomes in women with intrahepatic cholestasis of pregnancy. Diabetol Metab Syndr 2024; 16:57. [PMID: 38429774 PMCID: PMC10908036 DOI: 10.1186/s13098-024-01294-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/17/2024] [Indexed: 03/03/2024] Open
Abstract
PURPOSE To evaluate the effect of intrahepatic cholestasis of pregnancy (ICP) with gestational diabetes mellitus (GDM) on perinatal outcomes and establish a prediction model of adverse perinatal outcomes in women with ICP. METHODS This multicenter retrospective cohort study included the clinical data of 2,178 pregnant women with ICP, including 1,788 women with ICP and 390 co-occurrence ICP and GDM. The data of all subjects were collected from hospital electronic medical records. Univariate and multivariate logistic regression analysis were used to compare the incidence of perinatal outcomes between ICP with GDM group and ICP alone group. RESULTS Baseline characteristics of the population revealed that maternal age (p < 0.001), pregestational weight (p = 0.01), pre-pregnancy BMI (p < 0.001), gestational weight gain (p < 0.001), assisted reproductive technology (ART) (p < 0.001), and total bile acid concentration (p = 0.024) may be risk factors for ICP with GDM. Furthermore, ICP with GDM demonstrated a higher association with both polyhydramnios (OR 2.66) and preterm labor (OR 1.67) compared to ICP alone. Further subgroup analysis based on the severity of ICP showed that elevated total bile acid concentrations were closely associated with an increased risk of preterm labour, meconium-stained amniotic fluid, and low birth weight in both ICP alone and ICP with GDM groups. ICP with GDM further worsened these outcomes, especially in women with severe ICP. The nomogram prediction model effectively predicted the occurrence of preterm labour in the ICP population. CONCLUSIONS ICP with GDM may result in more adverse pregnancy outcomes, which are associated with bile acid concentrations.
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Affiliation(s)
- Xia Li
- Department of Bioinformatics, School of Basic Medical Sciences , Chongqing Medical University, No.1 Yixueyuan Rd, Yuzhong District, 400016, Chongqing, China
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China
| | - Qin-Yu Cai
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China
| | - Xin Luo
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Yong-Heng Wang
- Department of Bioinformatics, School of Basic Medical Sciences , Chongqing Medical University, No.1 Yixueyuan Rd, Yuzhong District, 400016, Chongqing, China
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China
| | - Li-Zhen Shao
- Department of Bioinformatics, School of Basic Medical Sciences , Chongqing Medical University, No.1 Yixueyuan Rd, Yuzhong District, 400016, Chongqing, China
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China
| | - Shu-Juan Luo
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China
| | - Lan Wang
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China
| | - Ying-Xiong Wang
- Department of Bioinformatics, School of Basic Medical Sciences , Chongqing Medical University, No.1 Yixueyuan Rd, Yuzhong District, 400016, Chongqing, China
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China
| | - Xia Lan
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China.
| | - Tai-Hang Liu
- Department of Bioinformatics, School of Basic Medical Sciences , Chongqing Medical University, No.1 Yixueyuan Rd, Yuzhong District, 400016, Chongqing, China.
- Joint International Research Laboratory of Reproduction & Development, Chongqing Medical University, 400016, Chongqing, China.
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Zhao X, Yao T, Song B, Fan H, Liu T, Gao G, Wang K, Lu W, Liu C. The combination of body mass index and fasting plasma glucose is associated with type 2 diabetes mellitus in Japan: a secondary retrospective analysis. Front Endocrinol (Lausanne) 2024; 15:1355180. [PMID: 38419956 PMCID: PMC10899432 DOI: 10.3389/fendo.2024.1355180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background Body mass index (BMI) and fasting plasma glucose (FPG) are known risk factors for type 2 diabetes mellitus (T2DM), but data on the prospective association of the combination of BMI and FPG with T2DM are limited. This study sought to characterize the association of the combination of BMI and FPG (ByG) with T2DM. Methods The current study used the NAGALA database. We categorized participants by tertiles of ByG. The association of ByG with T2DM was expressed with hazard ratios (HRs) with 95% confidence intervals (CIs) after adjustment for potential risk factors. Results During a median follow-up of 6.19 years in the normoglycemia cohort and 5.58 years in the prediabetes cohort, the incidence of T2DM was 0.75% and 7.79%, respectively. Following multivariable adjustments, there were stepwise increases in T2DM with increasing tertiles of ByG. After a similar multivariable adjustment, the risk of T2DM was 2.57 (95% CI 2.26 - 2.92), 1.97 (95% CI 1.53 - 2.54) and 1.50 (95% CI 1.30 - 1.74) for a per-SD change in ByG in all populations, the normoglycemia cohort and the prediabetes cohort, respectively. Conclusion ByG was associated with an increased risk of T2DM in Japan. The result reinforced the importance of the combination of BMI and FPG in assessing T2DM risk.
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Affiliation(s)
| | | | | | | | | | | | | | - Weilin Lu
- *Correspondence: Weilin Lu, ; Chengyun Liu,
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Chi D, Zhu M, Dong G, Gao H, Xiang W, Ye Q, Fu J. Family History of Type 2 Diabetes and Its Association with Beta Cell Function and Lipid Profile in Newly Diagnosed Pediatric Patients with Type 1 Diabetes. Endocr Res 2024; 49:117-123. [PMID: 38676343 DOI: 10.1080/07435800.2024.2339934] [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: 12/29/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE The objective of this study was to explore the associations between a family history of type 2 diabetes (T2D) and beta-cell function, as well as lipid profile, in pediatric patients newly diagnosed with type 1 diabetes (T1D). METHODS A retrospective analysis was conducted on children under 14 years of age who were newly diagnosed with T1D at the Children's Hospital of Zhejiang University between August 2018 and August 2022. Clinical features, metabolic profiles, beta-cell function, and lipid profile were evaluated. RESULTS A total of 316 children were diagnosed with new-onset T1D. Among them, 28.2% had a family history of T2D. Patients with T1D who had a family history of T2D experienced a later onset of the disease (p = 0.016), improved HOMA2-%B levels (p = 0.003), and increased concentrations of HDL-C (p = 0.005). In addition, no statistically significant differences in age at onset, HOMA2-%B levels, or HDL-C were found when assessing the interaction between family history of T2D and type of diabetes mellitus (autoimmune T1D/idiopathic T1D). CONCLUSION A family history of T2D may contribute to the heterogeneity of T1D patients in terms of HOMA2-%B levels and lipid profile. This highlights the significance of taking into account T2D-related factors in the diagnosis and treatment of T1D.
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Affiliation(s)
- Dan Chi
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Mingqiang Zhu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Guanping Dong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hui Gao
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Wenqing Xiang
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Qing Ye
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Junfen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Arunachalam LT, Suresh S, Lavu V, Vedamanickam S, Viswanathan S, Thirumalai Nathan RD. Association of salivary levels of DNA sensing inflammasomes AIM2, IFI16, and cytokine IL18 with periodontitis and diabetes. J Periodontol 2024; 95:114-124. [PMID: 37480196 DOI: 10.1002/jper.23-0184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Aberrant deoxyribonucleic acid (DNA) contributes to inflammasome orchestrated progression of chronic inflammatory diseases like diabetes and periodontitis. The purpose of the present study was to estimate salivary levels of DNA sensing inflammasomes, absent in melanoma 2 (AIM2), interferon γ inducible protein (IFI16), and cytokine interleukin 18 (IL18) in individuals with periodontitis, diabetes, and healthy controls and interpret its association with periodontal and diabetic parameters. METHODS Salivary levels of AIM2, IFI16, and IL18 were estimated by enzyme linked immunosorbent assay (ELISA) in a total of 120 individuals (n = 30 in each group), namely, healthy (Group 1), periodontitis (Group 2), diabetes (Group 3), and diabetes with periodontitis (Group 4). Correlations of inflammasome levels and periodontal clinical parameters-plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), and periodontal inflamed surface area (PISA) were performed. Multiple regression was carried out to predict AIM2 and IFI16 with various independent variables. RESULTS The mean salivary levels of AIM2, IFI16, and IL18 were highest in diabetes with periodontitis (Group 4) and least in healthy (Group 1) and statistically significant between the groups (p = 0.000). Significant positive correlation between clinical periodontal parameters and AIM2, IFI16, and IL18 was present (p ≤ 0.05). Multiple regression showed glycated hemoglobin (HbA1C) (p = 0.002), GI (p = 0.016), PISA (p = 0.002), and CAL (p = 0.004) were significant predictors of AIM2, while HbA1C (p = 0.012), PISA (p = 0.003), and CAL (p = 0.007) predicted IFI16. CONCLUSION The results of the present study showed higher levels of AIM2, IFI16, and IL18 in saliva of individuals with diabetes and periodontitis. HbA1C, PISA, and CAL were significant independent predictors of salivary AIM2 and IFI16 levels.
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Affiliation(s)
| | - Snophia Suresh
- Department of Periodontics, Thai Moogambigai Dental College & Hospital, Chennai, India
| | - Vamsi Lavu
- Department of Periodontics, Sri Ramachandra Dental College & Hospital, Chennai, India
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Nisar MI, das S, Khanam R, Khalid J, Chetia S, Hasan T, Shahid S, Marijani ML, Ahmed S, Khalid F, Ali SM, Chowdhury NH, Mehmood U, Dutta A, Rahman S, Qazi MF, Deb S, Mitra DK, Usmani AA, Dhingra U, Raqib R, Manu A, Yoshida S, Minckas N, Bahl R, Baqui AH, Sazawal S, Jehan F. Early to mid-pregnancy HbA1c levels and its association with adverse pregnancy outcomes in three low middle-income countries in Asia and Sub-Saharan Africa. BMC Pregnancy Childbirth 2024; 24:66. [PMID: 38225559 PMCID: PMC10789021 DOI: 10.1186/s12884-023-06241-w] [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: 08/15/2023] [Accepted: 12/31/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Hyperglycemia during pregnancy leads to adverse maternal and fetal outcomes. Thus, strict monitoring of blood glucose levels is warranted. This study aims to determine the association of early to mid-pregnancy HbA1c levels with the development of pregnancy complications in women from three countries in South Asia and Sub-Saharan Africa. METHODS We performed a secondary analysis of the AMANHI (Alliance for Maternal and Newborn Health Improvement) cohort, which enrolled 10,001 pregnant women between May 2014 and June 2018 across Sylhet-Bangladesh, Karachi-Pakistan, and Pemba Island-Tanzania. HbA1c assays were performed at enrollment (8 to < 20 gestational weeks), and epidemiological data were collected during 2-3 monthly household visits. The women were followed-up till the postpartum period to determine the pregnancy outcomes. Multivariable logistic regression models assessed the association between elevated HbA1c levels and adverse events while controlling for potential confounders. RESULTS A total of 9,510 pregnant women were included in the analysis. The mean HbA1c level at enrollment was found to be the highest in Bangladesh (5.31 ± 0.37), followed by Tanzania (5.22 ± 0.49) and then Pakistan (5.07 ± 0.58). We report 339 stillbirths and 9,039 live births. Among the live births were 892 preterm births, 892 deliveries via cesarean section, and 532 LGA babies. In the multivariate pooled analysis, maternal HbA1c levels of ≥ 6.5 were associated with increased risks of stillbirths (aRR = 6.3, 95% CI = 3.4,11.6); preterm births (aRR = 3.5, 95% CI = 1.8-6.7); and Large for Gestational Age (aRR = 5.5, 95% CI = 2.9-10.6). CONCLUSION Maternal HbA1c level is an independent risk factor for predicting adverse pregnancy outcomes such as stillbirth, preterm birth, and LGA among women in South Asia and Sub-Saharan Africa. These groups may benefit from early interventional strategies.
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Affiliation(s)
- Muhammad Imran Nisar
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Sayan das
- Center for Public Health Kinetics, New Delhi, India
| | - Rasheda Khanam
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Maryland, Baltimore, USA
| | - Javairia Khalid
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | | | - Tarik Hasan
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - Shahira Shahid
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | | | | | - Farah Khalid
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | | | | | - Usma Mehmood
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Arup Dutta
- Center for Public Health Kinetics, New Delhi, India
| | - Sayedur Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Muhammad Farrukh Qazi
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Saikat Deb
- Center for Public Health Kinetics, New Delhi, India
- Public Health Laboratory-IDC, Pemba, Tanzania
| | - Dipak Kumar Mitra
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Asra Abeer Usmani
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Usha Dhingra
- Center for Public Health Kinetics, New Delhi, India
| | - Rubhana Raqib
- International Center for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Alexander Manu
- London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Sachiyo Yoshida
- Department for Maternal, Child, Adolescents and Ageing Health, World Health Organization (MCA/MRD), Avenue Appia 20, Geneva, 1211, Switzerland.
| | - Nicole Minckas
- Department for Maternal, Child, Adolescents and Ageing Health, World Health Organization (MCA/MRD), Avenue Appia 20, Geneva, 1211, Switzerland
| | - Rajiv Bahl
- Department for Maternal, Child, Adolescents and Ageing Health, World Health Organization (MCA/MRD), Avenue Appia 20, Geneva, 1211, Switzerland
| | - Abdullah H Baqui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Maryland, Baltimore, USA
| | | | - Fyezah Jehan
- Department of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
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Lu HY, Ding X, Hirst JE, Yang Y, Yang J, Mackillop L, Clifton DA. Digital Health and Machine Learning Technologies for Blood Glucose Monitoring and Management of Gestational Diabetes. IEEE Rev Biomed Eng 2024; 17:98-117. [PMID: 37022834 PMCID: PMC7615520 DOI: 10.1109/rbme.2023.3242261] [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] [Indexed: 02/10/2023]
Abstract
Innovations in digital health and machine learning are changing the path of clinical health and care. People from different geographical locations and cultural backgrounds can benefit from the mobility of wearable devices and smartphones to monitor their health ubiquitously. This paper focuses on reviewing the digital health and machine learning technologies used in gestational diabetes - a subtype of diabetes that occurs during pregnancy. This paper reviews sensor technologies used in blood glucose monitoring devices, digital health innovations and machine learning models for gestational diabetes monitoring and management, in clinical and commercial settings, and discusses future directions. Despite one in six mothers having gestational diabetes, digital health applications were underdeveloped, especially the techniques that can be deployed in clinical practice. There is an urgent need to (1) develop clinically interpretable machine learning methods for patients with gestational diabetes, assisting health professionals with treatment, monitoring, and risk stratification before, during and after their pregnancies; (2) adapt and develop clinically-proven devices for patient self-management of health and well-being at home settings ("virtual ward" and virtual consultation), thereby improving clinical outcomes by facilitating timely intervention; and (3) ensure innovations are affordable and sustainable for all women with different socioeconomic backgrounds and clinical resources.
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Jia G, Bai H, Mather B, Hill MA, Jia G, Sowers JR. Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights. Int J Mol Sci 2024; 25:804. [PMID: 38255878 PMCID: PMC10815704 DOI: 10.3390/ijms25020804] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/26/2023] [Accepted: 01/07/2024] [Indexed: 01/24/2024] Open
Abstract
Clinical and basic studies have documented that both hyperglycemia and insulin-resistance/hyperinsulinemia not only constitute metabolic disorders contributing to cardiometabolic syndrome, but also predispose to diabetic vasculopathy, which refers to diabetes-mellitus-induced microvascular and macrovascular complications, including retinopathy, neuropathy, atherosclerosis, coronary artery disease, hypertension, and peripheral artery disease. The underlying molecular and cellular mechanisms include inappropriate activation of the renin angiotensin-aldosterone system, mitochondrial dysfunction, excessive oxidative stress, inflammation, dyslipidemia, and thrombosis. These abnormalities collectively promote metabolic disorders and further promote diabetic vasculopathy. Recent evidence has revealed that endothelial progenitor cell dysfunction, gut dysbiosis, and the abnormal release of extracellular vesicles and their carried microRNAs also contribute to the development and progression of diabetic vasculopathy. Therefore, clinical control and treatment of diabetes mellitus, as well as the development of novel therapeutic strategies are crucial in preventing cardiometabolic syndrome and related diabetic vasculopathy. The present review focuses on the relationship between insulin resistance and diabetes mellitus in diabetic vasculopathy and related cardiovascular disease, highlighting epidemiology and clinical characteristics, pathophysiology, and molecular mechanisms, as well as management strategies.
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Affiliation(s)
- George Jia
- Department of Medicine—Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA; (G.J.); (H.B.); (B.M.)
- Department of Biology, Washington University in St Louis, St. Louis, MO 63130, USA
| | - Hetty Bai
- Department of Medicine—Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA; (G.J.); (H.B.); (B.M.)
| | - Bethany Mather
- Department of Medicine—Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA; (G.J.); (H.B.); (B.M.)
| | - Michael A. Hill
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA;
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, USA
| | - Guanghong Jia
- Department of Medicine—Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA; (G.J.); (H.B.); (B.M.)
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, USA
| | - James R. Sowers
- Department of Medicine—Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA; (G.J.); (H.B.); (B.M.)
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA;
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, USA
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Huttunen-Lenz M, Hansen S, Raben A, Westerterp-Plantenga M, Adam T, Macdonald I, Stratton G, Swindell N, Martinez JA, Navas-Carretero S, Handjieva-Darlenska T, Handjiev S, Poppitt SD, Silvestre MP, Larsen TM, Vestentoft PS, Fogelholm M, Jalo E, Brand-Miller J, Muirhead R, Schlicht W. Hybrid Evaluation of a Lifestyle Change Program to Prevent the Development of Type 2 Diabetes Among Individuals With Prediabetes: Intended and Observed Changes in Intervening Mechanisms. J Prim Care Community Health 2024; 15:21501319241248223. [PMID: 38916158 PMCID: PMC11459537 DOI: 10.1177/21501319241248223] [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: 11/02/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Lifestyle interventions can prevent type 2 diabetes (T2D) by successfully inducing behavioral changes (eg, avoiding physical inactivity and sedentariness, increasing physical activity and/or healthy eating) that reduce body weight and normalize metabolic levels (eg, HbA1c). For interventions to be successful, it is important to influence "behavioral mechanisms" such as self-efficacy, which motivate behavioral changes. Theory-based expectations of how self-efficacy, chronic stress, and mood changed over time were investigated through a group-based behavior change intervention (PREMIT). At 8 intervention sites, PREMIT was offered by trained primary care providers in 18 group-sessions over a period of 36 months, divided into 4 intervention phases. Adherence to the intervention protocol was assessed. METHOD Participants (n = 962) with overweight and prediabetes who had achieved ≥8% weight loss during a diet reduction period and completed the intervention were categorized into 3 groups: infrequent, frequent, or very frequent group sessions attendance. The interactions between participation in the group sessions and changes in self-efficacy, stress, and mood were multivariate tested. Intervention sites were regularly asked where and how they deviated from the intervention protocol. RESULTS There was no increase in the participants' self-efficacy in any group. However, the level of self-efficacy was maintained among those who attended the group sessions frequently, while it decreased in the other groups. For all participants, chronic stress and the frequency of attending group sessions were inversely related. Significant differences in mood were found for all groups. All intervention centers reported specific activities, additional to intervention protocol, to promote participation in the group sessions. CONCLUSIONS The results suggest that the behavioral changes sought by trained primary care providers are related to attendance frequency and follow complex trajectories. The findings also suggest that group-based interventions in naturalistic primary care settings aimed at preventing T2D require formats and strategies that encourage participants to attend group sessions regularly.
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Affiliation(s)
| | | | - Anne Raben
- University of Copenhagen, Frederiksberg, Denmark
- Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Herlev, Denmark
| | | | - Tanja Adam
- Maastricht University, Maastricht, The Netherlands
| | - Ian Macdonald
- University of Nottingham, Nottingham, UK
- Nestle Research, Lausanne, Switzerland
| | | | | | - J. Alfredo Martinez
- University of Navarra, Pamplona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
- IMDEAfood Madrid, Madrid, Spain
- IDISNA Navarra, Pamplona, Spain
| | - Santiago Navas-Carretero
- University of Navarra, Pamplona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | | | | | | | - Marta P. Silvestre
- University of Auckland, Auckland, New Zealand
- NOVA University of Lisbon, Lisbon, Portugal
| | | | | | | | - Elli Jalo
- University of Helsinki, Helsinki, Finland
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Liu Z. Efficacy of metformin combined with liraglutide on the glucose and lipid metabolism, vascular endothelial function, and oxidative stress of patients with T2DM and metabolic syndrome. Pak J Med Sci 2024; 40:26-30. [PMID: 38196473 PMCID: PMC10772425 DOI: 10.12669/pjms.40.1.7936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 03/30/2023] [Accepted: 07/23/2023] [Indexed: 01/11/2024] Open
Abstract
Objective This study evaluates the impact of metformin combined with liraglutide on the glucose and lipid metabolism, oxidative stress, and vascular endothelium of patients with type-2 diabetes mellitus (T2DM) and metabolic syndrome. Methods Medical records of 78 patients with T2DM and metabolic syndrome, admitted to Caoxian People's Hospital from July 2021 to July 2022, were retrospectively analysed. Thirty five patients were treated with metformin (control group), and 43 patients were treated with metformin combined with liraglutide (observation group). Indexes of glucose and lipid metabolism, function of vascular endothelium and the oxidative stress of both groups were compared before and after the treatment. Results There was a significant decrease in the levels of fasting plasma glucose (FPG), Glycosylated Hemoglobin A1c (HbA1c), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP) and waist circumference in both groups three months after the treatment, These indexes were significantly lower in the observation group compared to the control group (P<0.05). High-density lipoprotein cholesterol (HDL-C) levels were higher in the observation group (P<0.05). There was a significant improvement in the levels of nitric oxide (NO), endothelin-1 (ET-1), superoxide dismutase (SOD), and malondialdehyde (MDA) after the treatment, and these indexes were markedly better in the observation group compared to the control group (P<0.05). Conclusions Metformin combined with liraglutide treatment is associated with better outcomes than metformin alone in patients with T2DM and metabolic syndrome. Combined treatment results in improved glucose and lipid metabolism, vascular endothelial function, and oxidative stress index values.
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Affiliation(s)
- Zaisheng Liu
- Zaisheng Liu Department of Endocrinology Caoxian People’s Hospital Cao Country, Heze City, Shandong Province 274400, P.R. China
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Moses JC, Adibi S, Wickramasinghe N, Nguyen L, Angelova M, Islam SMS. Non-invasive blood glucose monitoring technology in diabetes management: review. Mhealth 2023; 10:9. [PMID: 38323150 PMCID: PMC10839510 DOI: 10.21037/mhealth-23-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/07/2023] [Indexed: 02/08/2024] Open
Abstract
Diabetes is one of the leading non-communicable diseases globally, adversely impacting an individual's quality of life and adding a considerable burden to the healthcare systems. The necessity for frequent blood glucose (BG) monitoring and the inconveniences associated with self-monitoring of BG, such as pain and discomfort, has motivated the development of non-invasive BG approaches. However, the current research progress is slow, and only a few BG self-monitoring devices have made considerable progress. Hence, we evaluate the available non-invasive glucose monitoring technologies validated against BG recordings to provide future research direction to design, develop, and deploy self-monitoring of BG with integrated emerging technologies. We searched five databases, Embase, MEDLINE, Proquest, Scopus, and Web of Science, to assess the non-invasive technology's scope in the diabetes management paradigm published from 2000 to 2020. A total of three approaches to non-invasive screening, including saliva, skin, and breath, were identified and discussed. We observed a statistical relationship between BG measurements obtained from non-invasive methods and standard clinical measures. Opportunities exist for future research to advance research progress and facilitate early technology adoption for healthcare practice. The results promise clinical validity; however, formulating regulatory guidelines could foresee the deployment of approved non-invasive BG monitoring technologies in healthcare practice. Further, research prospects are there to design, develop, and deploy integrated diabetes management systems with mobile technologies, data analytics, and the internet of things (IoT) to deliver a personalised monitoring system.
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Affiliation(s)
- Jeban Chandir Moses
- School of Information Technology, Deakin University, Melbourne, VIC, Australia
| | - Sasan Adibi
- School of Information Technology, Deakin University, Melbourne, VIC, Australia
| | - Nilmini Wickramasinghe
- School of Computing, Engineering and Mathematical Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Lemai Nguyen
- Department of Information Systems and Business Analytics, Deakin Business School, Deakin University, Melbourne, VIC, Australia
| | - Maia Angelova
- School of Information Technology, Deakin University, Melbourne, VIC, Australia
- Aston Digital Futures Institute, College of Physical Sciences and Engineering, Aston University, Birmingham, UK
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Qiu J, Kuang M, He S, Yu C, Wang C, Huang X, Sheng G, Zou Y. Gender perspective on the association between liver enzyme markers and non-alcoholic fatty liver disease: insights from the general population. Front Endocrinol (Lausanne) 2023; 14:1302322. [PMID: 38125795 PMCID: PMC10731038 DOI: 10.3389/fendo.2023.1302322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Objective Every distinct liver enzyme biomarker exhibits a strong correlation with non-alcoholic fatty liver disease (NAFLD). This study aims to comprehensively analyze and compare the associations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) with NAFLD from a gender perspective. Methods This study was conducted on 6,840 females and 7,411 males from the NAGALA cohort. Multivariable logistic regression analysis was used to compare the associations between liver enzyme markers and NAFLD in both genders, recording the corresponding adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curves were used to evaluate the accuracy of individual liver enzyme markers and different combinations of them in identifying NAFLD. Results Liver enzyme markers ALT, AST, and GGT were all independently associated with NAFLD and exhibited significant gender differences (All P-interaction<0.05). In both genders, ALT exhibited the most significant association with NAFLD, with adjusted standardized ORs of 2.19 (95% CI: 2.01-2.39) in males and 1.60 (95% CI: 1.35-1.89) in females. Additionally, ROC analysis showed that ALT had significantly higher accuracy in identifying NAFLD than AST and GGT in both genders (Delong P-value < 0.05), and the accuracy of ALT in identifying NAFLD in males was higher than that in females [Area under the ROC curve (AUC): male 0.79, female 0.77]. Furthermore, out of the various combinations of liver enzymes, ALT+GGT showed the highest accuracy in identifying NAFLD in both genders, with AUCs of 0.77 (95% CI: 0.75-0.79) in females and 0.79 (95% CI: 0.78-0.81) in males. Conclusion Our study revealed significant gender differences in the associations of the three commonly used liver enzyme markers with NAFLD. In both genders, the use of ALT alone may be the simplest and most effective tool for screening NAFLD, especially in males.
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Affiliation(s)
- Jiajun Qiu
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Maobin Kuang
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Shiming He
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Changhui Yu
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Chao Wang
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Xin Huang
- Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Levin G, Tsur A, Tenenbaum L, Mor N, Zamir M, Meyer R. Second stage duration and delivery outcomes among women laboring after cesarean with no prior vaginal delivery. Birth 2023; 50:838-846. [PMID: 37367697 DOI: 10.1111/birt.12734] [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: 02/13/2022] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND We aimed to evaluate the association of the duration of the second stage with labor after cesarean (LAC) success and other outcomes among women with one prior cesarean delivery (CD) and no prior vaginal births. METHODS All women undergoing LAC that reached the second stage of labor from March 2011 to March 2020 were included in this retrospective cohort study. The primary outcome was the mode of delivery by second stage duration. The secondary outcomes included adverse maternal and neonatal outcomes. We allocated the study cohort into five groups of second stage duration. Further analysis compared <3 to ≥3 h of second stage based on prior studies. LAC success rates were compared. Composite maternal outcome was defined as the presence of uterine rupture/dehiscence, postpartum hemorrhage, or intrapartum/postpartum fever. RESULTS One thousand three hundred ninety seven deliveries were included. Vaginal birth after cesarean (VBAC) rates decreased as the second stage length time interval increased: 96.4% at <1 h, 94.9% at 1 to <2 h, 94.6% at 2 to <3 h, 92.1% at 3 to <4 h and 79.5% at ≥4 h (p < 0.001). Operative vaginal and CDs were significantly more likely as second stage duration time interval increased (p < 0.001). The composite maternal outcome was comparable among groups (p = 0.226). When comparing the outcomes of deliveries at <3 h versus ≥3 h, the composite maternal outcome and neonatal seizure rates were lower in the <3 h group (p = 0.041 and p = 0.047, respectively). CONCLUSION Vaginal birth after cesarean rates decreased as second stage time interval length increased. Even with prolonged second stage, VBAC rates remained relatively high. Increased risk of composite adverse maternal outcomes and neonatal seizures were observed when the second stage lasted 3 h or more.
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Affiliation(s)
- Gabriel Levin
- The Department of Obstetrics and Gynecology, Hadassah Medical Center, Jerusalem, Israel
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Tsur
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Gertner Institute for Epidemiology and Health Policy, Tel HaShomer, Israel
| | - Lee Tenenbaum
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nizan Mor
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Zamir
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Raanan Meyer
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
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Schweickart A, Batra R, Neth BJ, Martino C, Shenhav L, Zhang AR, Shi P, Karu N, Huynh K, Meikle PJ, Schimmel L, Dilmore AH, Blennow K, Zetterberg H, Blach C, Dorrestein PC, Knight R, Craft S, Kaddurah-Daouk R, Krumsiek J. A Modified Mediterranean Ketogenic Diet mitigates modifiable risk factors of Alzheimer's Disease: a serum and CSF-based metabolic analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.27.23298990. [PMID: 38076824 PMCID: PMC10705656 DOI: 10.1101/2023.11.27.23298990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Alzheimer's disease (AD) is influenced by a variety of modifiable risk factors, including a person's dietary habits. While the ketogenic diet (KD) holds promise in reducing metabolic risks and potentially affecting AD progression, only a few studies have explored KD's metabolic impact, especially on blood and cerebrospinal fluid (CSF). Our study involved participants at risk for AD, either cognitively normal or with mild cognitive impairment. The participants consumed both a modified Mediterranean-ketogenic diet (MMKD) and the American Heart Association diet (AHAD) for 6 weeks each, separated by a 6-week washout period. We employed nuclear magnetic resonance (NMR)-based metabolomics to profile serum and CSF and metagenomics profiling on fecal samples. While the AHAD induced no notable metabolic changes, MMKD led to significant alterations in both serum and CSF. These changes included improved modifiable risk factors, like increased HDL-C and reduced BMI, reversed serum metabolic disturbances linked to AD such as a microbiome-mediated increase in valine levels, and a reduction in systemic inflammation. Additionally, the MMKD was linked to increased amino acid levels in the CSF, a breakdown of branched-chain amino acids (BCAAs), and decreased valine levels. Importantly, we observed a strong correlation between metabolic changes in the CSF and serum, suggesting a systemic regulation of metabolism. Our findings highlight that MMKD can improve AD-related risk factors, reverse some metabolic disturbances associated with AD, and align metabolic changes across the blood-CSF barrier.
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Affiliation(s)
- Annalise Schweickart
- Tri-Institutional Program in Computational Biology & Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY 10021, USA
| | - Richa Batra
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY 10021, USA
| | | | - Cameron Martino
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Liat Shenhav
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Anru R. Zhang
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Pixu Shi
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Naama Karu
- Tasmanian Independent Metabolomics and Analytical Chemistry Solutions (TIMACS), Hobart, 7008 Tasmania, Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia
- Baker Department of Cardiovascular Research Translation and Implementation, La Trobe University, Bundoora, VIC, Australia
| | - Peter J. Meikle
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia
- Baker Department of Cardiovascular Research Translation and Implementation, La Trobe University, Bundoora, VIC, Australia
| | - Leyla Schimmel
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Colette Blach
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
| | - Pieter C Dorrestein
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA
| | - Rob Knight
- Departments of Pediatrics, Computer Science and Engineering, Bioengineering, University of California San Diego, La Jolla, CA
| | | | - Suzanne Craft
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Institute of Brain Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
| | - Jan Krumsiek
- Department of Physiology and Biophysics, Weill Cornell Medicine, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, New York, NY 10021, USA
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