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Koo HY, Cho IY, Han K, Lee KN, Cho MH, Jin SM, Cho YH, Lee JH, Park YJ, Shin DW. Editor's Choice - Glycaemic Status and Risk of Abdominal Aortic Aneurysm: A Nationwide Cohort Study of Four Million Adults using Korean National Health Screening Data. Eur J Vasc Endovasc Surg 2024; 68:479-487. [PMID: 38844129 DOI: 10.1016/j.ejvs.2024.05.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/10/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE This retrospective cohort study aimed to confirm the previously reported inverse association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) using large population based data. It also investigated the associations between AAA and impaired fasting glucose (IFG) and new onset DM (not yet treated). METHODS A representative dataset was obtained from the Korean National Health Insurance Service. Participants who were aged ≥ 50 years and received a national health examination in 2009 were included and followed until 31 December 2019. Glycaemic status was defined based on fasting plasma glucose level and the relevant diagnostic codes. AAA was ascertained using medical facility use records with relevant diagnostic codes or aneurysm repair surgery. A Cox proportional hazards model was used to examine the association between glycaemic status and AAA, with adjustment for confounders. Additionally, the interactions between glycaemic status and subgroups based on baseline characteristics were examined. RESULTS The study population comprised 4 162 640 participants. Participants with IFG or DM were significantly more likely to be male, older, and have comorbidities compared with normoglycaemic participants at baseline. The incidence of AAA was lower in participants with IFG or DM compared with normoglycaemic participants. The AAA risk was lower in patients with DM than in patients with IFG, and decreased linearly according to glycaemic status: the adjusted hazard ratio was 0.88 (95% confidence interval [CI] 0.85 - 0.91) for IFG, 0.72 (95% CI 0.67 - 0.78) for newly diagnosed DM, 0.65 (95% CI 0.61 - 0.69) for DM duration < 5 years, and 0.47 (95% CI 0.44 - 0.51) for DM duration ≥ 5 years compared with the normoglycaemia group. Both IFG and DM were related to reduced AAA risk in all subgroups, suggesting an independent association. CONCLUSION Both IFG and DM, even when not treated with antihyperglycaemic medication, were associated with a lower incidence of AAA. The AAA risk decreased linearly according to DM duration.
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Affiliation(s)
- Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In Young Cho
- Department of Family Medicine & Supportive Care Centre, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyu Na Lee
- Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi Hee Cho
- Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Man Jin
- Division of Endocrinology, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yang Hyun Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yang-Jin Park
- Division of Vascular Surgery, Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine & Supportive Care Centre, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design and Evaluation/Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
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Qiu L, Xiao Z, Fan B, Li L, Sun G. Association of body roundness index with diabetes and prediabetes in US adults from NHANES 2007-2018: a cross-sectional study. Lipids Health Dis 2024; 23:252. [PMID: 39154165 PMCID: PMC11330595 DOI: 10.1186/s12944-024-02238-2] [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: 07/13/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVE The present study examined the ability of the body roundness index (BRI) to predict the incidence of diabetes and prediabetes among adults in the USA. METHOD The study enrolled 11,980 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES). Logistic regression served as the primary method for analyzing the relevant link between BRI and the incidence of diabetes and prediabetes, including univariate analysis, multivariate regression analysis, smooth curve fitting analysis, and subgroup analysis. What's more, receiver operating characteristic (ROC) analysis was applied to confirm the predictive values of BRI for diabetes and prediabetes. RESULTS Each unit higher than BRI was associated with a 17% increased risk of diabetes and prediabetes after covariate adjustments (OR: 1.17, 95% CI: 1.07-1.27). Those with BRI in the high scores (Q4) possessed an increased likelihood of having diabetes and prediabetes than individuals in the reference group (OR: 1.83, 95% CI: 1.29-2.58). A smooth curve fitting analysis revealed a non-linear trend. The results across all population subgroups were uniform to those of the total population. The ROC curve indicated that the BRI was the best predictor of diabetes and prediabetes among other anthropometric indices. CONCLUSIONS Diabetes and prediabetes occurrence rates and BRI have a positive and non-linear relationship in American adults. The BRI indices could function as predictive markers for diabetes and prediabetes.
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Affiliation(s)
- Liting Qiu
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, 300 Road, Yuelu District, Changsha, 410208, Hunan Province, P. R. China
| | - Zixuan Xiao
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, 300 Road, Yuelu District, Changsha, 410208, Hunan Province, P. R. China
| | - Boyan Fan
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, 300 Road, Yuelu District, Changsha, 410208, Hunan Province, P. R. China
| | - Ling Li
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, 300 Road, Yuelu District, Changsha, 410208, Hunan Province, P. R. China.
| | - Guixiang Sun
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, 300 Road, Yuelu District, Changsha, 410208, Hunan Province, P. R. China.
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Zhang J, He M, Gao G, Sun T. Bibliometric analysis of research on the utilization of nanotechnology in diabetes mellitus and its complications. Nanomedicine (Lond) 2024; 19:1449-1469. [PMID: 39121376 PMCID: PMC11318711 DOI: 10.1080/17435889.2024.2358741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/20/2024] [Indexed: 08/11/2024] Open
Abstract
Aim: To identify hotspots in this field and provide insights into future research directions. Methods: Publications were retrieved from the Web of Science Core Collection database. R Bibliometrix software, VOSviewer and CiteSpace were used to perform the bibliometric and visualization analyses. Results: The analysis comprised 468 publications from 58 countries, with the United States, China and India being the leading contributors. 'Gene therapy', 'nanoparticles' and 'insulin therapy' are the primary focuses. 'Green synthesis', 'cytotoxicity', 'bioavailability' and 'diabetic foot ulcers' have gained prominence, signifying high-intensity areas of interest expected to persist as favored research topics in the future. Conclusion: This study delves into recent frontiers and topical research directions and provides valuable references for further research in this field.
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Affiliation(s)
- Jiexin Zhang
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, School of Chemistry, Chemical Engineering & Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan430070, P. R. China
| | - Meng He
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, School of Chemistry, Chemical Engineering & Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan430070, P. R. China
| | - Guanbin Gao
- State Key Laboratory of Advanced Technology for Materials Synthesis & Processing, Wuhan University of Technology, 122 Luoshi Road, Wuhan430070, P. R. China
| | - Taolei Sun
- Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, School of Chemistry, Chemical Engineering & Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan430070, P. R. China
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Ravi H, Das S, Devi Rajeswari V, Venkatraman G, Choudhury AA, Chakraborty S, Ramanathan G. Hormonal regulation in diabetes: Special emphasis on sex hormones and metabolic traits. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2024; 142:257-291. [PMID: 39059988 DOI: 10.1016/bs.apcsb.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Diabetes constitutes a significant global public health challenge that is rapidly reaching epidemic proportions. Among the non-communicable diseases, the incidence of diabetes is rising at an alarming rate. The International Diabetes Federation has documented a 9.09% prevalence of diabetes among individuals aged between 20 and 79 years. The interplay of gonadal hormones and gender differences is critical in regulating insulin sensitivity and glucose tolerance, and this dynamic is particularly crucial because of the escalating incidence of diabetes. Variations in insulin sensitivity are observed across genders, levels of adiposity, and age groups. Both estrogen and testosterone are seen to influence glucose metabolism and insulin sensitivity. This chapter surveys the present knowledge of sex differences, sex hormones, and chromosomes on insulin imbalance and diabetes development. It further highlights the influence of metabolic traits in diabetes and changes in sex hormones during diabetic pregnancy. Notably, even stressful lifestyles have been acknowledged to induce hormonal imbalances. Furthermore, it discusses the potential of hormonal therapy to help stabilize sex hormones in diabetic individuals and focuses on the most recent research investigating the correlation between sex hormones and diabetes.
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Affiliation(s)
- Harini Ravi
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Soumik Das
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - V Devi Rajeswari
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Ganesh Venkatraman
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Abbas Alam Choudhury
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Shreya Chakraborty
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Gnanasambandan Ramanathan
- Department of Bio-Medical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India.
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Gupta OT, Gupta RK. The Expanding Problem of Regional Adiposity: Revisiting a 1985 Diabetes Classic by Ohlson et al. Diabetes 2024; 73:649-652. [PMID: 38640415 PMCID: PMC11043052 DOI: 10.2337/dbi24-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 04/21/2024]
Abstract
Body fat distribution is a predictor of metabolic health in obesity. In this Classics in Diabetes article, we revisit a 1985 Diabetes article by Swedish investigators Ohlson et al. This work was one of the first prospective population-based studies that established a relationship between abdominal adiposity and the risk for developing diabetes. Here, we discuss evolving concepts regarding the link between regional adiposity and diabetes and other chronic disorders. Moreover, we highlight fundamental questions that remain unresolved.
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Affiliation(s)
- Olga T. Gupta
- Division of Endocrinology and Diabetes, Department of Pediatrics, Duke University, Durham, NC
| | - Rana K. Gupta
- Division of Endocrinology, Department of Medicine, Duke Molecular Physiology Institute, Duke University, Durham, NC
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Cao B, Li K, Ke J, Zhao D. Impaired Sensitivity to Thyroid Hormones Is Associated With the Change of Abdominal Fat in Euthyroid Type 2 Diabetes Patients: A Retrospective Cohort Study. J Diabetes Res 2024; 2024:8462987. [PMID: 38712310 PMCID: PMC11073852 DOI: 10.1155/2024/8462987] [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: 10/29/2023] [Revised: 03/26/2024] [Accepted: 04/06/2024] [Indexed: 05/08/2024] Open
Abstract
Background and Aims: This study is aimed at investigating the potential correlation of thyroid hormone sensitivity with visceral fat area (VFA), subcutaneous fat area (SFA), and body mass index (BMI) among euthyroid type 2 diabetes mellitus (T2DM) subjects. Methods: Thyroid hormone sensitivity indices were calculated by thyroid feedback quantile-based index (TFQI), TSH index (TSHI), thyrotropin thyroxine resistance index (TT4RI), and free thyroxine (fT4)/free triiodothyronine (fT3) ratio. These indices were then categorized into quartiles for analysis. The outcomes were the change rates in VFA, SFA, and BMI among the participants. Result: The present study included 921 patients, with a median follow-up of 2.2 years. In multivariate linear regression, when compared to the first quartile, SFA demonstrated a notable decline in the fourth quartile of TFQI, TSHI, and TT4RI (β coefficient = -5.78, -7.83, and - 6.84 cm2 per year), while it significantly increased in the fourth quartile of fT4/fT3 ratio (β coefficient = 6.13 cm2 per year). Similarly, in the fourth quartile of TFQI, TSHI, and TT4RI, VFA decreased significantly, evidenced by β coefficients of -5.14, -4.80, and -4.08 cm2 per year. Yet, among the quartiles of the fT4/fT3 ratio, no discernible trend in VFA was observed. There was no significant association between indices of thyroid hormone sensitivity and change in BMI. Conclusion: Impaired central sensitivity to thyroid hormones was significantly associated with the reduction of VFA and SFA, while impaired peripheral sensitivity was associated with an increase of SFA in euthyroid individuals with T2DM.
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Affiliation(s)
- Bin Cao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Kun Li
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Jing Ke
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
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Jalil JE, Gabrielli L, Ocaranza MP, MacNab P, Fernández R, Grassi B, Jofré P, Verdejo H, Acevedo M, Cordova S, Sanhueza L, Greig D. New Mechanisms to Prevent Heart Failure with Preserved Ejection Fraction Using Glucagon-like Peptide-1 Receptor Agonism (GLP-1 RA) in Metabolic Syndrome and in Type 2 Diabetes: A Review. Int J Mol Sci 2024; 25:4407. [PMID: 38673991 PMCID: PMC11049921 DOI: 10.3390/ijms25084407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
This review examines the impact of obesity on the pathophysiology of heart failure with preserved ejection fraction (HFpEF) and focuses on novel mechanisms for HFpEF prevention using a glucagon-like peptide-1 receptor agonism (GLP-1 RA). Obesity can lead to HFpEF through various mechanisms, including low-grade systemic inflammation, adipocyte dysfunction, accumulation of visceral adipose tissue, and increased pericardial/epicardial adipose tissue (contributing to an increase in myocardial fat content and interstitial fibrosis). Glucagon-like peptide 1 (GLP-1) is an incretin hormone that is released from the enteroendocrine L-cells in the gut. GLP-1 reduces blood glucose levels by stimulating insulin synthesis, suppressing islet α-cell function, and promoting the proliferation and differentiation of β-cells. GLP-1 regulates gastric emptying and appetite, and GLP-1 RA is currently indicated for treating type 2 diabetes (T2D), obesity, and metabolic syndrome (MS). Recent evidence indicates that GLP-1 RA may play a significant role in preventing HFpEF in patients with obesity, MS, or obese T2D. This effect may be due to activating cardioprotective mechanisms (the endogenous counter-regulatory renin angiotensin system and the AMPK/mTOR pathway) and by inhibiting deleterious remodeling mechanisms (the PKA/RhoA/ROCK pathway, aldosterone levels, and microinflammation). However, there is still a need for further research to validate the impact of these mechanisms on humans.
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Affiliation(s)
- Jorge E. Jalil
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Luigi Gabrielli
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - María Paz Ocaranza
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Paul MacNab
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Rodrigo Fernández
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Bruno Grassi
- Pontificia Universidad Católica de Chile, School of Medicine, Department of Nutrition and Diabetes, Santiago 8330055, Chile; (B.G.); (P.J.)
| | - Paulina Jofré
- Pontificia Universidad Católica de Chile, School of Medicine, Department of Nutrition and Diabetes, Santiago 8330055, Chile; (B.G.); (P.J.)
| | - Hugo Verdejo
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Monica Acevedo
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Samuel Cordova
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Luis Sanhueza
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
| | - Douglas Greig
- Pontificia Universidad Católica de Chile, School of Medicine, Division of Cardiovascular Diseases, Santiago 8330055, Chile; (L.G.); (P.M.); (R.F.); (H.V.); (M.A.); (S.C.); (L.S.); (D.G.)
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Chi JH, Lee BJ. Association of relative hand grip strength with myocardial infarction and angina pectoris in the Korean population: a large-scale cross-sectional study. BMC Public Health 2024; 24:941. [PMID: 38566101 PMCID: PMC10986018 DOI: 10.1186/s12889-024-18409-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: 09/08/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Low hand grip strength (HGS) is associated with the risk of cardiovascular diseases, but the association between HGS and myocardial infarction/angina pectoris (MIAP) is unclear. Furthermore, there have been no studies examining the associations of MIAP with anthropometric indices, absolute HGS indices, and relative HGS indices calculated by dividing absolute HGS values by body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), or weight values. Therefore, the objective of this study was to examine the associations of MIAP with absolute and relative HGS combined with several anthropometric indices. METHODS In this large-scale cross-sectional study, a total of 12,963 subjects from the National Health and Nutrition Examination Survey were included. Odds ratios and 95% confidence intervals for the associations of MIAP with anthropometric indices, absolute HGS indices, and relative HGS indices were computed from binary logistic regression models. We built 3 models: a crude model, a model that was adjusted for age (Model 1), and a model that was adjusted for other relevant covariates (Model 2). RESULTS For men, the average age was 61.55 ± 0.16 years in the MIAP group and 66.49 ± 0.61 years in the non-MIAP group. For women, the average age was 61.99 ± 0.14 years in the MIAP group and 70.48 ± 0.61 years in the non-MIAP group. For both sexes, the MIAP group had lower diastolic blood pressure, shorter stature, greater WC, and a greater WHtR than did the non-MIAP group, and women tended to have greater systolic blood pressure, weight, and BMI than in men. HGS was strongly associated with the risk of MIAP in the Korean population. In men, relative HGS indices combined with WC and the WHtR had greater associations with MIAP than did the anthropometric indices and absolute HGS indices. However, in women, anthropometric indices, including weight, BMI, WC, and WHtR, were more strongly associated with MIAP than were absolute and relative HGS indices, unlike in men. When comparing absolute and relative HGS indices in women, relative HGS indices combined with BMI and weight was more strongly related to MIAP than was absolute HGS indices. CONCLUSIONS MIAP might be better identified by relative HGS than absolute HGS in both sexes. The overall magnitudes of the associations of MIAP with absolute and relative HGS are greater in men than in women.
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Affiliation(s)
- Jeong Hee Chi
- Department of Computer Science and Engineering, Konkuk University, Seoul, Republic of Korea
| | - Bum Ju Lee
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, 34054, Daejeon, Republic of Korea.
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Bahadoran Z, Mirmiran P, Ghasemi A. Adipose organ dysfunction and type 2 diabetes: Role of nitric oxide. Biochem Pharmacol 2024; 221:116043. [PMID: 38325496 DOI: 10.1016/j.bcp.2024.116043] [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: 10/30/2023] [Revised: 01/07/2024] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
Adipose organ, historically known as specialized lipid-handling tissue serving as the long-term fat depot, is now appreciated as the largest endocrine organ composed of two main compartments, i.e., subcutaneous and visceral adipose tissue (AT), madding up white and beige/brown adipocytes. Adipose organ dysfunction manifested as maldistribution of the compartments, hypertrophic, hypoxic, inflamed, and insulin-resistant AT, contributes to the development of type 2 diabetes (T2D). Here, we highlight the role of nitric oxide (NO·) in AT (dys)function in relation to developing T2D. The key aspects determining lipid and glucose homeostasis in AT depend on the physiological levels of the NO· produced via endothelial NO· synthases (eNOS). In addition to decreased NO· bioavailability (via decreased expression/activity of eNOS or scavenging NO·), excessive NO· produced by inducible NOS (iNOS) in response to hypoxia and AT inflammation may be a critical interfering factor diverting NO· signaling to the formation of reactive oxygen and nitrogen species, resulting in AT and whole-body metabolic dysfunction. Pharmacological approaches boosting AT-NO· availability at physiological levels (by increasing NO· production and its stability), as well as suppression of iNOS-NO· synthesis, are potential candidates for developing NO·-based therapeutics in T2D.
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Affiliation(s)
- Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Zuraikat FM, Laferrère B, Cheng B, Scaccia SE, Cui Z, Aggarwal B, Jelic S, St-Onge MP. Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial. Diabetes Care 2024; 47:117-125. [PMID: 37955852 PMCID: PMC10733650 DOI: 10.2337/dc23-1156] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Insufficient sleep is associated with type 2 diabetes, yet the causal impact of chronic insufficient sleep on glucose metabolism in women is unknown. We investigated whether prolonged mild sleep restriction (SR), resembling real-world short sleep, impairs glucose metabolism in women. RESEARCH DESIGN AND METHODS Women (aged 20-75 years) without cardiometabolic diseases and with actigraphy-confirmed habitual total sleep time (TST) of 7-9 h/night were recruited to participate in this randomized, crossover study with two 6-week phases: maintenance of adequate sleep (AS) and 1.5 h/night SR. Outcomes included plasma glucose and insulin levels, HOMA of insulin resistance (HOMA-IR) values based on fasting blood samples, as well as total area under the curve for glucose and insulin, the Matsuda index, and the disposition index from an oral glucose tolerance test. RESULTS Our sample included 38 women (n = 11 postmenopausal women). Values are reported with ±SEM. Linear models adjusted for baseline outcome values demonstrated that TST was reduced by 1.34 ± 0.04 h/night with SR versus AS (P < 0.0001). Fasting insulin (β = 6.8 ± 2.8 pmol/L; P = 0.016) and HOMA-IR (β = 0.30 ± 0.12; P = 0.016) values were increased with SR versus AS, with effects on HOMA-IR more pronounced in postmenopausal women compared with premenopausal women (β = 0.45 ± 0.25 vs. β = 0.27 ± 0.13, respectively; P for interaction = 0.042). Change in adiposity did not mediate the effects of SR on glucose metabolism or change results in the full sample when included as a covariate. CONCLUSIONS Curtailing sleep duration to 6.2 h/night, reflecting the median sleep duration of U.S. adults with short sleep, for 6 weeks impairs insulin sensitivity, independent of adiposity. Findings highlight insufficient sleep as a modifiable risk factor for insulin resistance in women to be targeted in diabetes prevention efforts.
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Affiliation(s)
- Faris M. Zuraikat
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
| | - Blandine Laferrère
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
- Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Bin Cheng
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Samantha E. Scaccia
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Zuoqiao Cui
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Brooke Aggarwal
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Sanja Jelic
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Marie-Pierre St-Onge
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
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11
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Wu T, Yang-Huang J, Vernooij MW, Rodriguez-Ayllon M, Jaddoe VWV, Raat H, Klein S, Oei EHG. Physical activity, screen time and body composition in 13-year-old adolescents: The Generation R Study. Pediatr Obes 2023; 18:e13076. [PMID: 37699652 DOI: 10.1111/ijpo.13076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Body composition between prepubertal children and adolescents varies, and it is unclear how physical activity and sedentary behaviour affect adolescent body composition. OBJECTIVES This study aimed to examine the associations of physical activity and screen time with overall and specific fat depots in the general adolescent population. METHODS In a population-based prospective cohort study, among 3258 adolescents aged 13 years, physical activity and screen time were assessed via self-report questionnaires. Body mass index, dual-energy X-ray absorptiometry-based measures (i.e. fat mass and lean body mass) and magnetic resonance imaging-based measures (i.e. abdominal subcutaneous and visceral fat mass) were obtained. RESULTS After adjusting for social-demographic and growth-related factors, each additional hour of daily physical activity was associated with lower fat mass, abdominal visceral fat mass and higher lean body mass (all p < 0.05). However, these associations were not observed in the longitudinal analyses. Each additional hour of daily screen time was associated with higher body mass index, fat mass, abdominal subcutaneous and visceral fat mass (all p < 0.05), which were consistent with the longitudinal analyses. CONCLUSION Adolescents with higher physical activity and lower screen time had lower levels of adiposity both at the general and visceral levels.
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Affiliation(s)
- Tong Wu
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Junwen Yang-Huang
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - María Rodriguez-Ayllon
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Stefan Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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12
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Tong KI, Hopstock LA, Cook S. Association of C-reactive protein with future development of diabetes: a population-based 7-year cohort study among Norwegian adults aged 30 and older in the Tromsø Study 2007-2016. BMJ Open 2023; 13:e070284. [PMID: 37775289 PMCID: PMC10546179 DOI: 10.1136/bmjopen-2022-070284] [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: 11/17/2022] [Accepted: 08/29/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVES The extent to which observed associations between high-sensitivity C-reactive protein (hs-CRP) and incident diabetes are explained by obesity and hypertension remains unclear. This study aimed to investigate the association of hs-CRP with developing diabetes in a Norwegian general population sample. DESIGN A cohort study using two population-based surveys of the Tromsø Study: the sixth survey Tromsø6 (2007-2008) as baseline and the seventh survey Tromsø7 (2015-2016) at follow-up. SETTING Tromsø municipality of Norway, a country with increasing proportion of older adults and a high prevalence of overweight, obesity and hypertension. PARTICIPANTS 8067 women and men without diabetes, aged 30-87 years, at baseline Tromsø6 who subsequently also participated in Tromsø7. OUTCOME MEASURES Diabetes defined by self-reported diabetes, diabetes medication use and/or HbA1c≥6.5% (≥48 mmol/mol) was modelled by logistic regression for the association with baseline hs-CRP, either stratified into three quantiles or as continuous variable, adjusted for demographic factors, behavioural and cardiovascular risk factors, lipid-lowering medication use, and hypertension. Interactions by sex, body mass index (BMI), hypertension or abdominal obesity were assessed by adding interaction terms in the fully adjusted model. RESULTS There were 320 (4.0%) diabetes cases after 7 years. After multivariable adjustment including obesity and hypertension, individuals in the highest hs-CRP tertile 3 had 73% higher odds of developing diabetes (OR 1.73; p=0.004; 95% CI 1.20 to 2.49) when compared with the lowest tertile or 28% higher odds of incidence per one-log of hs-CRP increment (OR 1.28; p=0.003; 95% CI 1.09 to 1.50). There was no evidence for interaction between hs-CRP and sex, hypertension, BMI or abdominal obesity. CONCLUSIONS Raised hs-CRP was associated with future diabetes development in a Norwegian adult population sample. The CRP-diabetes association could not be fully explained by obesity or hypertension.
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Affiliation(s)
- Kit I Tong
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | | | - Sarah Cook
- School of Public Health, Imperial College London, London, UK
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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13
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Crummett LT, Aslam MH. Diabetes websites lack information on dietary causes, risk factors, and preventions for type 2 diabetes. Front Public Health 2023; 11:1159024. [PMID: 37521964 PMCID: PMC10373935 DOI: 10.3389/fpubh.2023.1159024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Type 2 diabetes (T2D) is a growing public health burden throughout the world. Many people looking for information on how to prevent T2D will search on diabetes websites. Multiple dietary factors have a significant association with T2D risk, such as high intake of added sugars, refined carbohydrates, saturated fat, and red meat or processed meat; and decreased intake of dietary fiber, and fruits/vegetables. Despite this dietary information being available in the scientific literature, it is unclear whether this information is available in gray literature (websites). Objective In this study, we evaluate the use of specific terms from diabetes websites that are significantly associated with causes/risk factors and preventions for T2D from three term categories: (A) dietary factors, (B) nondietary nongenetic (lifestyle-associated) factors, and (C) genetic (non-modifiable) factors. We also evaluate the effect of website type (business, government, nonprofit) on term usage among websites. Methods We used web scraping and coding tools to quantify the use of specific terms from 73 diabetes websites. To determine the effect of term category and website type on the usage of specific terms among 73 websites, a repeated measures general linear model was performed. Results We found that dietary risk factors that are significantly associated with T2D (e.g., sugar, processed carbohydrates, dietary fat, fruits/vegetables, fiber, processed meat/red meat) were mentioned in significantly fewer websites than either nondietary nongenetic factors (e.g., obesity, physical activity, dyslipidemia, blood pressure) or genetic factors (age, family history, ethnicity). Among websites that provided "eat healthy" guidance, one third provided zero dietary factors associated with type 2 diabetes, and only 30% provided more than two specific dietary factors associates with type 2 diabetes. We also observed that mean percent usage of all terms associated with T2D causes/risk factors and preventions was significantly lower among government websites compared to business websites and nonprofit websites. Conclusion Diabetes websites need to increase their usage of dietary factors when discussing causes/risk factors and preventions for T2D; as dietary factors are modifiable and strongly associated with all nondietary nongenetic risk factors, in addition to T2D risk.
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14
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Laber S, Strobel S, Mercader JM, Dashti H, dos Santos FR, Kubitz P, Jackson M, Ainbinder A, Honecker J, Agrawal S, Garborcauskas G, Stirling DR, Leong A, Figueroa K, Sinnott-Armstrong N, Kost-Alimova M, Deodato G, Harney A, Way GP, Saadat A, Harken S, Reibe-Pal S, Ebert H, Zhang Y, Calabuig-Navarro V, McGonagle E, Stefek A, Dupuis J, Cimini BA, Hauner H, Udler MS, Carpenter AE, Florez JC, Lindgren C, Jacobs SB, Claussnitzer M. Discovering cellular programs of intrinsic and extrinsic drivers of metabolic traits using LipocyteProfiler. CELL GENOMICS 2023; 3:100346. [PMID: 37492099 PMCID: PMC10363917 DOI: 10.1016/j.xgen.2023.100346] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 08/22/2022] [Accepted: 05/26/2023] [Indexed: 07/27/2023]
Abstract
A primary obstacle in translating genetic associations with disease into therapeutic strategies is elucidating the cellular programs affected by genetic risk variants and effector genes. Here, we introduce LipocyteProfiler, a cardiometabolic-disease-oriented high-content image-based profiling tool that enables evaluation of thousands of morphological and cellular profiles that can be systematically linked to genes and genetic variants relevant to cardiometabolic disease. We show that LipocyteProfiler allows surveillance of diverse cellular programs by generating rich context- and process-specific cellular profiles across hepatocyte and adipocyte cell-state transitions. We use LipocyteProfiler to identify known and novel cellular mechanisms altered by polygenic risk of metabolic disease, including insulin resistance, fat distribution, and the polygenic contribution to lipodystrophy. LipocyteProfiler paves the way for large-scale forward and reverse deep phenotypic profiling in lipocytes and provides a framework for the unbiased identification of causal relationships between genetic variants and cellular programs relevant to human disease.
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Affiliation(s)
- Samantha Laber
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7FZ, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Sophie Strobel
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
| | - Josep M. Mercader
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - Hesam Dashti
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
- The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Felipe R.C. dos Santos
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Phil Kubitz
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Life Sciences, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
- The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Maya Jackson
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Alina Ainbinder
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Julius Honecker
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Life Sciences, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
| | - Saaket Agrawal
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Garrett Garborcauskas
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - David R. Stirling
- Imaging Platform, Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Aaron Leong
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - Katherine Figueroa
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Nasa Sinnott-Armstrong
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Department of Genetics, Stanford University, San Francisco, CA, USA
| | - Maria Kost-Alimova
- Imaging Platform, Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Giacomo Deodato
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Alycen Harney
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Gregory P. Way
- Imaging Platform, Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Alham Saadat
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Sierra Harken
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Saskia Reibe-Pal
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7FZ, UK
| | - Hannah Ebert
- Institute of Nutritional Science, University Hohenheim, 70599 Stuttgart, Germany
| | - Yixin Zhang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Virtu Calabuig-Navarro
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Institute of Nutritional Science, University Hohenheim, 70599 Stuttgart, Germany
| | - Elizabeth McGonagle
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Adam Stefek
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1G1, Canada
| | - Beth A. Cimini
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Life Sciences, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Miriam S. Udler
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - Anne E. Carpenter
- Imaging Platform, Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Jose C. Florez
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
| | - Cecilia Lindgren
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7FZ, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Suzanne B.R. Jacobs
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Melina Claussnitzer
- Programs in Metabolism and Medical and Population Genetics, Type 2 Diabetes Systems Genomics Initiative, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02114, USA
- The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
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Lin Y, Zhong X, Lu D, Yao W, Zhou J, Wu R, Feng F. Association of visceral and subcutaneous fat with bone mineral density in US adults: a cross-sectional study. Sci Rep 2023; 13:10682. [PMID: 37393338 PMCID: PMC10314932 DOI: 10.1038/s41598-023-37892-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/29/2023] [Indexed: 07/03/2023] Open
Abstract
The relationship between the accumulation of fat in visceral or subcutaneous tissue and bone mineral density (BMD) remains unclear. Our primary objective in this study was to illuminate this relationship by conducting an investigation on a vast scale, encompassing a nationally representative population in the United States. A weighted multiple linear regression model was established to evaluate the relationship between visceral fat, subcutaneous fat, and BMD. Additionally, the exploration of the potential nonlinear relationship was conducted employing the methodology of smooth curve fitting. In order to determine potential inflection points, a two-stage linear regression model was utilized. A total of 10,455 participants between the ages of 20 and 59 were included in this study. Various weighted multiple linear regression models revealed a negative correlation between lumbar BMD and visceral mass index (VMI) and subcutaneous mass index (SMI). However, the association between VMI and lumbar BMD displayed a U-shaped pattern upon employing the smooth curve fitting, and the inflection point of 0.304 kg/m2was determined using a two-stage linear regression model. Our findings indicated a negative association between subcutaneous fat and BMD. A U-shaped relationship was observed between visceral fat and BMD.
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Affiliation(s)
- Yanze Lin
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xugang Zhong
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Qingdao University, Qingdao, China
| | - Dongning Lu
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenchao Yao
- Department of Orthopaedics, The First People's Hospital of Chun'an County, Hangzhou, Zhejiang, China
| | - Jinlei Zhou
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ruiji Wu
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fabo Feng
- Center for Plastic and Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
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16
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Popoviciu MS, Păduraru L, Yahya G, Metwally K, Cavalu S. Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials. Int J Mol Sci 2023; 24:10449. [PMID: 37445623 DOI: 10.3390/ijms241310449] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Obesity is a chronic disease with high prevalence and associated comorbidities, making it a growing global concern. These comorbidities include type 2 diabetes, hypertension, ventilatory dysfunction, arthrosis, venous and lymphatic circulation diseases, depression, and others, which have a negative impact on health and increase morbidity and mortality. GLP-1 agonists, used to treat type 2 diabetes, have been shown to be effective in promoting weight loss in preclinical and clinical studies. This review summarizes numerous studies conducted on the main drugs in the GLP-1 agonists class, outlining the maximum achievable weight loss. Our aim is to emphasize the active role and main outcomes of GLP-1 agonists in promoting weight loss, as well as in improving hyperglycemia, insulin sensitivity, blood pressure, cardio-metabolic, and renal protection. We highlight the pleiotropic effects of these medications, along with their indications, contraindications, and precautions for both diabetic and non-diabetic patients, based on long-term follow-up studies.
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Affiliation(s)
- Mihaela-Simona Popoviciu
- Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 Decembrie 10, 410073 Oradea, Romania
| | - Lorena Păduraru
- Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 Decembrie 10, 410073 Oradea, Romania
| | - Galal Yahya
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Al Sharqia 44519, Egypt
- Department of Molecular Genetics, Faculty of Biology, Technical University of Kaiserslautern, Paul-Ehrlich Str. 24, 67663 Kaiserslautern, Germany
| | - Kamel Metwally
- Department of Medicinal Chemistry, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
- Department of Pharmaceutical Medicinal Chemistry, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 Decembrie 10, 410073 Oradea, Romania
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17
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Tang H, Ling J, Meng H, Wu L, Zhu L, Zhu S. Temporal Relationship Between Insulin Resistance and Lipid Accumulation After Bariatric Surgery: a Multicenter Cohort Study. Obes Surg 2023:10.1007/s11695-023-06508-3. [PMID: 37060490 DOI: 10.1007/s11695-023-06508-3] [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: 01/08/2022] [Revised: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 04/16/2023]
Abstract
PURPOSE Insulin resistance (IR) is closely associated with lipid accumulation. Here, we investigated the temporal relationship between the two conditions after bariatric surgery. MATERIALS AND METHODS In total, 409 participants were enrolled from three bariatric centers in China from 2009 to 2018. We evaluated whether baseline IR (proxied by homeostasis model assessment of insulin resistance (HOMA-IR)) and lipid accumulation (proxied by visceral adiposity index (VAI) and lipid accumulation product (LAP)) were associated with follow-up IR and lipid accumulation (3 months postoperatively) using linear regression models. We then conducted a cross-lagged panel analysis model to simultaneously examine the bidirectional relationship between IR and lipid accumulation. RESULTS Multivariable linear regression analyses showed that baseline HOMA-IR was associated with follow-up VAI (β = 0.430, 95% CI: 0.082-0.778, p = 0.016) and LAP (β = 0.070, 95% CI: 0.010-0.130, p = 0.022). There was no relationship between baseline lipid accumulation and follow-up IR. Further cross-lagged panel analyses indicated that the path coefficient from baseline HOMA-IR to follow-up VAI (β2 = 0.145, p = 0.003) was significantly greater than the coefficient from baseline VAI to follow-up HOMA-IR (β1 = - 0.013, p = 0.777). Similarly, the path coefficient from baseline HOMA-IR to follow-up LAP (β2 = 0.141, p = 0.003) was significantly greater than the coefficient from baseline LAP to follow-up HOMA-IR (β1 = 0.041, p = 0.391). CONCLUSION Our study demonstrated a unidirectional relationship from HOMA-IR to VAI and LAP, suggesting that the change in IR may precede lipid accumulation after surgery.
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Affiliation(s)
- Haibo Tang
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jiapu Ling
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hua Meng
- Department of General Surgery, The China-Japan Friendship Hospital, Beijing, China
| | - Liangping Wu
- Department of Metabolic Surgery, The Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liyong Zhu
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Shaihong Zhu
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, Changsha, China.
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18
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Mazor R, Babkin A, Littrup PJ, Alloush M, Sturek M, Byrd JP, Hernandez E, Bays H, Grunvald E, Mattar SG. Mesenteric fat cryolipolysis attenuates insulin resistance in the Ossabaw swine model of the metabolic syndrome. Surg Obes Relat Dis 2023; 19:374-383. [PMID: 36443211 PMCID: PMC10040421 DOI: 10.1016/j.soard.2022.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/26/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The rising prevalence of insulin resistance (IR), metabolic syndrome, and type 2 diabetes are associated with increases in abdominal mesenteric fat. Adipocytes are sensitive to low temperatures, making cryolipolysis of mesenteric fat an attractive treatment modality to potentially reduce IR. OBJECTIVES We aimed to determine whether (1) cryolipolysis is safe in reducing the volume of the mesenteric fat and (2) reduction in mesenteric fat volume reduces indices of IR and glycemic dysfunction. SETTING Indiana University School of Medicine. METHODS A novel cooling device and method delivered cryolipolysis in a controlled manner to avoid tissue ablative temperatures. Ossabaw pigs (n = 8) were fed a high-fat diet for 9 months to develop visceral obesity, IR, and metabolic syndrome. Following laparotomy, mesenteric fat cryolipolysis (MFC) was performed in 5 pigs, while 3 served as sham surgery controls. The volume of the mesenteric fat was measured by computed tomography and compared with indices of glucose intolerance before and at 3 and 6 months postprocedure. RESULTS MFC safely reduced mesenteric fat volume by ∼30% at 3 months, which was maintained at 6 months. Body weight did not change in either the MFC or sham surgery control groups. Measure of glycemic control, insulin sensitivity, and blood pressure significantly improved after MFC compared with sham controls. CONCLUSION MFC reduces the volume of mesenteric fat and improves glycemic control in obese, IR Ossabaw pigs, without adverse effects.
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Affiliation(s)
| | | | - Peter J Littrup
- Department of Radiology, Wayne State University, Detroit, Michigan; Department of Radiology, Ascension Providence Rochester Hospital, Rochester, Michigan
| | - Mouhamad Alloush
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael Sturek
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - James P Byrd
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Edward Hernandez
- Section of Minimally Invasive and Bariatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Harold Bays
- Louisville Metabolic and Atherosclerosis Research Center, Inc., Louisville, Kentucky
| | - Eduardo Grunvald
- Division of General Internal Medicine, Department of Medicine, University of California, San Diego, California; Bariatric and Metabolic Institute, Division of Minimally Invasive Surgery, Department of Surgery, University of California, San Diego, California
| | - Samer G Mattar
- Department of Surgery, Baylor College of Medicine, Houston, Texas
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19
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Pathophysiology of Prediabetes, Diabetes, and Diabetic Remission in Cats. Vet Clin North Am Small Anim Pract 2023; 53:511-529. [PMID: 36898862 DOI: 10.1016/j.cvsm.2023.02.001] [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: 03/10/2023]
Abstract
Diabetes mellitus (DM) has a heterogenous cause, and the exact pathogenesis differs between patients. Most diabetic cats have a cause similar to human type 2 DM but, in some, DM is associated with underlying conditions, such as hypersomatotropism, hyperadrenocorticism, or administration of diabetogenic drugs. Predisposing factors for feline DM include obesity, reduced physical activity, male sex, and increasing age. Gluco(lipo)toxicity and genetic predisposition also likely play roles in pathogenesis. Prediabetes cannot be accurately diagnosed in cats at the current time. Diabetic cats can enter remission, but relapses are common, as these cats might have ongoing, abnormal glucose homeostasis.
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20
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Chung TL, Liu YH, Wu PY, Huang JC, Chen SC. Sex difference in the associations among obesity-related indices with incidence of diabetes mellitus in a large Taiwanese population follow-up study. Front Public Health 2023; 11:1094471. [PMID: 36741951 PMCID: PMC9895090 DOI: 10.3389/fpubh.2023.1094471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/02/2023] [Indexed: 01/21/2023] Open
Abstract
Background Obesity is a major risk factor for diabetes mellitus (DM), which is in turn a major risk factor for cardiovascular diseases such as coronary artery disease and stroke. As few studies have investigated sex differences in the association between obesity and incidence of DM, the aim of this longitudinal study was to explore this issue in a large group of Taiwanese participants. Methods A total of 24,346 participants were enrolled in this study, of whom 8,334 (mean age, 50.6 ± 11.0 years) were male and 16,012 (mean age, 50.5 ± 10.1 years) were female. The following obesity-related indices were studied: body mass index, waist-to-height ratio, waist-to-hip ratio (WHR), body roundness index, conicity index (CI), body adiposity index, abdominal volume index, lipid accumulation product (LAP), and visceral adiposity index (VAI). Results The analysis showed significant associations between all of these indices with incidence of DM (all p < 0.001). In the male participants, the strongest predictors for incidence of DM were LAP (AUC = 0.692), WHtR (AUC = 0.684), and WHR (AUC = 0.683). In the female participants, the strongest predictors were LAP (AUC = 0.744), WHtR (AUC = 0.710) and VAI (AUC = 0.710), followed by BRI (AUC = 0.708). Conclusion Strong associations were found between the studied obesity-related indices and incidence of DM, and sex differences were found. Hence, to better control DM, reducing body weight may be beneficial in addition to lifestyle modifications, diet control, and pharmacological interventions.
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Affiliation(s)
- Tung-Ling Chung
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yi-Hsueh Liu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Chi Huang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,*Correspondence: Szu-Chia Chen ✉
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21
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Lyu Z, Zhao M, Atanes P, Persaud SJ. Quantification of changes in human islet G protein-coupled receptor mRNA expression in obesity. Diabet Med 2022; 39:e14974. [PMID: 36260369 DOI: 10.1111/dme.14974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/13/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND G protein-coupled receptors (GPCRs) play crucial roles in regulating islet function, with Gαs- and Gαq-coupled receptors being linked to the stimulation of insulin secretion. We have quantified the mRNA expression of 384 non-olfactory GPCRs in islets isolated from lean and obese organ donors to determine alterations in islet GPCR mRNA expression in obesity. METHODS RT-qPCR was used to quantify GPCR mRNAs relative to five reference genes (ACTB, GAPDH, PPIA, TBP, and TFRC) in human islets isolated from lean (BMI = 22.6 ± 0.5) and obese (BMI = 32.0 ± 0.8) donors. RESULTS Overall, 197 and 256 GPCR mRNAs were detected above trace level in islets from lean and obese donors, respectively, with 191 GPCR mRNAs being common to the lean and obese groups. 40.9% (n = 157) and 27.1% (n = 104) of the mRNAs were expressed at trace level whilst 7.8% and 6.3% were absent in islets from lean and obese donors, respectively. Hundred and seventeen GPCR mRNAs were upregulated at least twofold in islets from obese donors, and there was >twofold downregulation of 21 GPCR mRNAs. Of particular interest, several receptors signalling via Gαs or Gαq showed significant mRNA upregulation in islets from obese donors (fold increase: PTH2R: 54.0 ± 14.6; MC2R: 34.3 ± 11.5; RXFP1: 8.5 ± 2.1; HTR2B: 6.0 ± 2.0; GPR110: 3.9 ± 1.2; PROKR2: 3.9 ± 0.7). CONCLUSIONS Under conditions of obesity, human islets showed significant alterations in mRNAs encoding numerous GPCRs. The increased expression of Gαs- and Gαq-coupled receptors that have not previously been investigated in β-cells opens up possibilities of novel therapeutic candidates that may lead to the potentiation of insulin secretion and/or β-cell mass to regulate glucose homeostasis.
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Affiliation(s)
- Zekun Lyu
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
| | - Min Zhao
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
| | - Patricio Atanes
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
| | - Shanta Jean Persaud
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
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22
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Huang S, Li Y, Jiang L, Ren Y, Wang J, Shi K, Yan WF, Qian WL, Yang ZG. Impact of Type 2 Diabetes Mellitus on Epicardial Adipose Tissue and Myocardial Microcirculation by MRI in Postmenopausal Women. J Magn Reson Imaging 2022; 56:1404-1413. [PMID: 35179821 DOI: 10.1002/jmri.28121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) often occurs conjunctly with the menopausal transition in female patients. In addition, epicardial adipose tissue (EAT) has an unfavorable impact on the myocardium and coronary arteries under the influence of metabolic disorders. PURPOSE To investigate the impact of T2DM on EAT and myocardial microvascular function in postmenopausal women. STUDY TYPE Retrospective. POPULATION One-hundred sixty-one postmenopausal women divided into three groups: newly diagnosed (≤5 years) T2DM (n = 56, 58.6 ± 7.7 years), long-term (>5 years) T2DM (n = 57, 61.9 ± 7.9 years), and healthy controls (n = 48, 59.4 ± 7.4 years). FIELD STRENGTH/SEQUENCE 3.0 T; balanced steady-state free precession and inversion recovery prepared echo-planar sequences. ASSESSMENT EAT volume was quantified by delineating the epicardial border and the visceral layer of pericardium on the short-axis cine stacks. Perfusion parameters including upslope, maximum signal intensity (MaxSI) and time to maximum signal intensity (TTM) were derived from the first-pass perfusion signal intensity-time curves. STATISTICAL TESTS One-way analysis of variance, Pearson's and Spearman correlation, and multivariable linear regression. Two-sided P < 0.05 was considered statistically significant. RESULTS EAT volume was significantly increased in diabetic postmenopausal women compared to the controls (48.4 ± 13.4 mL/m2 [newly diagnosed T2DM] vs. 58.4 ± 17.3 mL/m2 [long-term T2DM] vs. 35.8 ± 12.3 mL/m2 [controls]). Regarding perfusion parameters, upslope and MaxSI were significantly reduced (2.6 ± 1.0 [newly diagnosed T2DM] vs. 2.1 ± 0.8 [long-term T2DM] vs. 3.6 ± 1.3 [controls]; and 21.4 ± 6.9 [newly diagnosed T2DM] vs. 18.7 ± 6.4 [long-term T2DM] vs. 28.4 ± 8.6 [controls]), whereas TTM was significantly increased in the T2DM groups compared to the control group (23.6 ± 8.7 [newly diagnosed T2DM] vs. 27.1 ± 9.4 [long-term T2DM] vs. 21.4 ± 6.0 [controls]). Multivariable analysis (adjusted coefficient of determination [R2 ] = 0.489) showed that EAT volume (β = -0.610) and menopausal age (β = 0.433) were independently correlated with decreased perfusion upslope. DATA CONCLUSION Diabetic postmenopausal women had significantly higher EAT volume and more impaired microcirculation compared to the controls. Increased EAT volume and earlier menopausal age were independently associated with microvascular dysfunction in these patients. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Shan Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Ren
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Feng Yan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen-Lei Qian
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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23
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Jorge-Smeding E, Warnken T, Grob AJ, Feige K, Pudert T, Leung YH, Go YY, Kenez A. The sphingolipidome of plasma, liver, and adipose tissues and its association with insulin response to oral glucose testing in Icelandic horses. Am J Physiol Regul Integr Comp Physiol 2022; 323:R397-R409. [PMID: 35938687 DOI: 10.1152/ajpregu.00018.2022] [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: 11/22/2022]
Abstract
Insulin dysregulation (ID) is a determinant of equine metabolic syndrome. Among the sphingolipids, ceramides contribute to the development of ID; however, the crosstalk between the liver and adipose tissue (AT) depots and the variation among AT depots in terms of ceramide metabolism are not well-understood. We aimed to characterize the sphingolipidome of plasma, liver, and AT (nuchal, NUAT; subcutaneous, SCAT; omental, OMAT; retroperitoneal, RPAT) and their associations with insulin response to oral glucose testing (OGT) in normoinsulinemic and hyperinsulinemic horses. Plasma, liver, and AT samples were collected from 12 Icelandic horses upon euthanasia and analyzed by liquid chromatography-mass spectrometry. Eighty-four targeted compounds were effectively quantified. Comparing the AT depots, greater (FDR < 0.05) ceramide, dihydroceramide, and sphingomyelin concentrations and lower glucosyl- and galactosyl-ceramides were found in RPAT and OMAT than in NUAT and SCAT. Hyperinsulinemic response to OGT was associated with sphingolipidome alterations primarily in the RPAT and OMAT, while the NUAT sphingolipidome did not show signs of ceramide accumulation, which was inconsistent with the previously proposed role of nuchal adiposity in ID. The plasma sphingolipidome was not significantly associated with the liver or AT sphingolipidomes, indicating that plasma profiles are determined by an interplay of various organs. Further, hepatic sphingolipid profiles were not correlated with the profiles of AT depots. Finally, statistically valid partial least square regression models predicting insulin response were found in the plasma (Q2= 0.58, R2= 0.98), liver (Q2= 0.64, R2= 0.74), and RPAT (Q2= 0.68, R2= 0.79) sphingolipidome, but not in the other adipose tissues.
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Affiliation(s)
- Ezequiel Jorge-Smeding
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong SAR, China
| | - Tobias Warnken
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Anne Julia Grob
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Tanja Pudert
- Clinic for Horses, Department of Surgery and Orthopaedics, Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Germany
| | - Yue Hei Leung
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong SAR, China
| | - Yun Young Go
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong SAR, China
| | - Akos Kenez
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong SAR, China
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24
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Kim EH, Kim HK, Lee MJ, Bae SJ, Choe J, Jung CH, Kim CH, Park JY, Lee WJ. Sex Differences of Visceral Fat Area and Visceral-to-Subcutaneous Fat Ratio for the Risk of Incident Type 2 Diabetes Mellitus. Diabetes Metab J 2022; 46:486-498. [PMID: 34911174 PMCID: PMC9171158 DOI: 10.4093/dmj.2021.0095] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/30/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND This study aimed to determine the optimal cut-off values of visceral fat area (VFA) and visceral-to-subcutaneous fat ratio (VSR) for predicting incident type 2 diabetes mellitus (T2DM). METHODS A total of 10,882 individuals (6,835 men; 4,047 women) free of T2DM at baseline aged between 30 and 79 years who underwent abdominal computed tomography scan between 2012 and 2013 as a part of routine health check-ups were included and followed. VFA, subcutaneous fat area, and VSR on L3 vertebral level were measured at baseline. RESULTS During a median follow-up of 4.8 years, 730 (8.1% for men; 4.3% for women) incident cases of T2DM were identified. Receiver operating characteristic curve analysis showed that the optimal cut-off values of VFA and VSR for predicting incident T2DM were 130.03 cm2 and 1.08 in men, respectively, and 85.7 cm2 and 0.48 in women, respectively. Regardless of sex, higher VFA and VSR were significantly associated with a higher risk of incident T2DM. Compared with the lowest quartiles of VFA and VSR, the highest quartiles had adjusted odds ratios of 2.62 (95% confidence interval [CI], 1.73 to 3.97) and 1.55 (95% CI, 1.14 to 2.11) in men, respectively, and 32.49 (95% CI, 7.42 to 142.02) and 11.07 (95% CI, 3.89 to 31.50) in women, respectively. CONCLUSION Higher VFA and VSR at baseline were independent risk factors for the development of T2DM. Sex-specific reference values for visceral fat obesity (VFA ≥130 cm2 or VSR ≥1.0 in men; VFA ≥85 cm2 or VSR ≥0.5 in women) are proposed for the prediction of incident T2DM.
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Affiliation(s)
- Eun Hee Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Corresponding authors: Hong-Kyu Kim https://orcid.org/0000-0002-7606-3521 Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail:
| | - Min Jung Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Jin Bae
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Joong-Yeol Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Je Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Woo Je Lee https://orcid.org/0000-0002-9605-9693 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail:
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25
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van Velzen D, Wiepjes C, Nota N, van Raalte D, de Mutsert R, Simsek S, den Heijer M. Incident Diabetes Risk Is Not Increased in Transgender Individuals Using Hormone Therapy. J Clin Endocrinol Metab 2022; 107:e2000-e2007. [PMID: 34971391 PMCID: PMC9016430 DOI: 10.1210/clinem/dgab934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 11/22/2022]
Abstract
CONTEXT In trans women receiving hormone therapy, body fat and insulin resistance increases, with opposite effects in trans men. These metabolic alterations may affect the risk of developing type 2 diabetes in trans women and trans men. CONTEXT We aimed to compare the incidence of type 2 diabetes of adult trans women and trans men during hormone therapy with rates from their birth-assigned sex in the general population. METHODS Retrospective data from the Amsterdam Cohort of Gender Dysphoria with transgender individuals on hormone therapy between 1972 and 2018 were linked to a nationwide health data registry. Because no central registry of diabetes is available, the occurrence of diabetes was inferred from the first dispense of a glucose-lowering agent. Standardized incidence ratios (SIR) were computed for trans women and trans men in comparison with the same birth sex from the general population. RESULTS Compared with their birth-assigned sex in the general population, no difference in the incidence of type 2 diabetes mellitus was observed in trans women (N = 2585, 90 cases; SIR 0.94; 95% CI, 0.76-1.14) or trans men (N = 1514, 32 cases; SIR 1.40; 95% CI, 0.96-1.92). CONCLUSION Despite studies reporting an increase in insulin resistance in feminizing hormone therapy and a decrease in insulin resistance in masculinizing hormone therapy, the incidence of diabetes in transgender individuals after initiation of hormone therapy was not different compared with the general population.
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Affiliation(s)
- Daan van Velzen
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, 1081HV Amsterdam, the Netherlands
| | - Chantal Wiepjes
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, 1081HV Amsterdam, the Netherlands
| | - Nienke Nota
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, 1081HV Amsterdam, the Netherlands
- Northwest Clinics, Department of Endocrinology, 1815JD Alkmaar, the Netherlands
| | - Daniel van Raalte
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, 1081HV Amsterdam, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Centre, 2333ZA Leiden, the Netherlands
| | - Suat Simsek
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, 1081HV Amsterdam, the Netherlands
- Northwest Clinics, Department of Endocrinology, 1815JD Alkmaar, the Netherlands
| | - Martin den Heijer
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, 1081HV Amsterdam, the Netherlands
- Correspondence: Prof. M. den Heijer, MD PhD, Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Centre, Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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Dhore-Patil A, Thannoun T, Samson R, Le Jemtel TH. Diabetes Mellitus and Heart Failure With Preserved Ejection Fraction: Role of Obesity. Front Physiol 2022; 12:785879. [PMID: 35242044 PMCID: PMC8886215 DOI: 10.3389/fphys.2021.785879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/03/2021] [Indexed: 12/15/2022] Open
Abstract
Heart failure with preserved ejection fraction is a growing epidemic and accounts for half of all patients with heart failure. Increasing prevalence, morbidity, and clinical inertia have spurred a rethinking of the pathophysiology of heart failure with preserved ejection fraction. Unlike heart failure with reduced ejection fraction, heart failure with preserved ejection fraction has distinct clinical phenotypes. The obese-diabetic phenotype is the most often encountered phenotype in clinical practice and shares the greatest burden of morbidity and mortality. Left ventricular remodeling plays a major role in its pathophysiology. Understanding the interplay of obesity, diabetes mellitus, and inflammation in the pathophysiology of left ventricular remodeling may help in the discovery of new therapeutic targets to improve clinical outcomes in heart failure with preserved ejection fraction. Anti-diabetic agents like glucagon-like-peptide 1 analogs and sodium-glucose co-transporter 2 are promising therapeutic modalities for the obese-diabetic phenotype of heart failure with preserved ejection fraction and aggressive weight loss via lifestyle or bariatric surgery is still key to reverse adverse left ventricular remodeling. This review focuses on the obese-diabetic phenotype of heart failure with preserved ejection fraction highlighting the interaction between obesity, diabetes, and coronary microvascular dysfunction in the development and progression of left ventricular remodeling. Recent therapeutic advances are reviewed.
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Affiliation(s)
- Aneesh Dhore-Patil
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States.,Tulane University Heart and Vascular Institute, New Orleans, LA, United States
| | - Tariq Thannoun
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States.,Tulane University Heart and Vascular Institute, New Orleans, LA, United States
| | - Rohan Samson
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States.,Tulane University Heart and Vascular Institute, New Orleans, LA, United States
| | - Thierry H Le Jemtel
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States.,Tulane University Heart and Vascular Institute, New Orleans, LA, United States
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27
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Liu Q, Zhu Z, Kraft P, Deng Q, Stener-Victorin E, Jiang X. Genomic correlation, shared loci, and causal relationship between obesity and polycystic ovary syndrome: a large-scale genome-wide cross-trait analysis. BMC Med 2022; 20:66. [PMID: 35144605 PMCID: PMC8832782 DOI: 10.1186/s12916-022-02238-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/05/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The comorbidity between polycystic ovary syndrome (PCOS) and obesity has long been observed in clinical settings, but their shared genetic basis remains unclear. METHODS Leveraging summary statistics of large-scale GWAS(s) conducted in European-ancestry populations on body mass index (adult BMI, Nfemale=434,794; childhood BMI, N=39,620), waist-to-hip ratio (WHR, Nfemale=381,152), WHR adjusted for BMI (WHRadjBMI, Nfemale=379,501), and PCOS (Ncase=10,074, Ncontrol=103,164), we performed a large-scale genome-wide cross-trait analysis to quantify overall and local genetic correlation, to identify shared loci, and to infer causal relationship. RESULTS We found positive genetic correlations between PCOS and adult BMI (rg=0.47, P=2.19×10-16), childhood BMI (rg=0.31, P=6.72×10-5), and WHR (rg=0.32, P=1.34×10-10), all withstanding Bonferroni correction. A suggestive significant genetic correlation was found between PCOS and WHRadjBMI (rg=0.09, P=0.04). Partitioning the whole genome into 1703 nearly independent regions, we observed a significant local genetic correlation for adult BMI and PCOS at chromosome 18: 57630483-59020751. We identified 16 shared loci underlying PCOS and obesity-related traits via cross-trait meta-analysis including 9 loci shared between BMI and PCOS (adult BMI and PCOS: 5 loci; childhood BMI and PCOS: 4 loci), 6 loci shared between WHR and PCOS, and 5 loci shared between WHRadjBMI and PCOS. Mendelian randomization (MR) supported the causal roles of both adult BMI (OR=2.92, 95% CI=2.33-3.67) and childhood BMI (OR=2.76, 95% CI=2.09-3.66) in PCOS, but not WHR (OR=1.19, 95% CI=0.93-1.52) or WHRadjBMI (OR=1.03, 95% CI=0.87-1.22). Genetic predisposition to PCOS did not seem to influence the risk of obesity-related traits. CONCLUSIONS Our cross-trait analysis suggests a shared genetic basis underlying obesity and PCOS and provides novel insights into the biological mechanisms underlying these complex traits. Our work informs public health intervention by confirming the important role of weight management in PCOS prevention.
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Affiliation(s)
- Qianwen Liu
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Zhaozhong Zhu
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Peter Kraft
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qiaolin Deng
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | | | - Xia Jiang
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Solna, Stockholm, Sweden.
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Dysregulated Epicardial Adipose Tissue as a Risk Factor and Potential Therapeutic Target of Heart Failure with Preserved Ejection Fraction in Diabetes. Biomolecules 2022; 12:biom12020176. [PMID: 35204677 PMCID: PMC8961672 DOI: 10.3390/biom12020176] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
Cardiovascular (CV) disease and heart failure (HF) are the leading cause of mortality in type 2 diabetes (T2DM), a metabolic disease which represents a fast-growing health challenge worldwide. Specifically, T2DM induces a cluster of systemic metabolic and non-metabolic signaling which may promote myocardium derangements such as inflammation, fibrosis, and myocyte stiffness, which represent the hallmarks of heart failure with preserved ejection fraction (HFpEF). On the other hand, several observational studies have reported that patients with T2DM have an abnormally enlarged and biologically transformed epicardial adipose tissue (EAT) compared with non-diabetic controls. This expanded EAT not only causes a mechanical constriction of the diastolic filling but is also a source of pro-inflammatory mediators capable of causing inflammation, microcirculatory dysfunction and fibrosis of the underlying myocardium, thus impairing the relaxability of the left ventricle and increasing its filling pressure. In addition to representing a potential CV risk factor, emerging evidence shows that EAT may guide the therapeutic decision in diabetic patients as drugs such as metformin, glucagon-like peptide‑1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 inhibitors (SGLT2-Is), have been associated with attenuation of EAT enlargement.
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Lin X, Chen Z, Huang H, Zhong J, Xu L. Diabetic kidney disease progression is associated with decreased lower-limb muscle mass and increased visceral fat area in T2DM patients. Front Endocrinol (Lausanne) 2022; 13:1002118. [PMID: 36277706 PMCID: PMC9582837 DOI: 10.3389/fendo.2022.1002118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
AIM This study aimed to explore the relationship between lower-limb muscle mass/visceral fat area and diabetic kidney disease (DKD) progression in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 879 participants with T2DM were divided into 4 groups according to the prognosis of CKD classification from Kidney Disease: Improving Global Outcomes (KDIGO). Rectus femoris cross-sectional area (RFCSA) was measured through ultrasound, and visceral fat area (VFA) was evaluated with bioelectric impedance analysis (BIA). RESULTS T2DM patients with high to very high prognostic risk of DKD showed a reduced RFCSA (male P < 0.001; female P < 0.05), and an enlarged VFA (male P < 0.05; female P < 0.05). The prognostic risk of DKD was negatively correlated with RFCSA (P < 0.05), but positively correlated with VFA (P < 0.05). Receiver-operating characteristic analysis revealed that the cutoff points of T2DM duration combined with RFCSA and VFA were as follows: (male: 7 years, 6.60 cm2, and 111 cm2; AUC = 0.82; 95% CI: 0.78-0.88; sensitivity, 78.0%; specificity, 68.6%, P < 0.001) (female: 9 years, 5.05 cm2, and 91 cm2; AUC = 0.73; 95% CI: 0.66-0.81; sensitivity, 73.9%; specificity, 63.3%, P < 0.001). CONCLUSION A significant association was demonstrated between reduced RFCSA/increased VFA and high- to very high-prognostic risk of DKD. T2DM duration, RFCSA, and VFA may be valuable markers of DKD progression in patients with T2DM. CLINICAL TRIAL REGISTRATION http://www.chictr.org.cn, identifier ChiCTR2100042214.
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Affiliation(s)
- Xiaopu Lin
- Department of Huiqiao Medical Centre, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhenguo Chen
- Department of Endocrinology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- The Third School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Haishan Huang
- Department of Endocrinology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- The Third School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jingyi Zhong
- Department of Endocrinology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- The Third School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Lingling Xu
- Department of Endocrinology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- *Correspondence: Lingling Xu,
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30
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Li Y, Zheng R, Li S, Cai R, Ni F, Zheng H, Hu R, Sun T. Association Between Four Anthropometric Indexes and Metabolic Syndrome in US Adults. Front Endocrinol (Lausanne) 2022; 13:889785. [PMID: 35685216 PMCID: PMC9171391 DOI: 10.3389/fendo.2022.889785] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/25/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To study the association between anthropometric indexes [lipid accumulation products (LAP), visceral obesity index (VAI), triglyceride and glucose index (TyG) and waist triglyceride index (WTI)] and metabolic syndrome (MetS) in a representative sample of American adult population surveyed by National Health and Nutrition Examination Survey (NHANES). METHODS Cross-sectional data from the NHANES were used. Participants were adults aged 18-80 y from 1996-2006. MetS were defined by the updated National Cholesterol Education Program/Adult Treatment Panel III criteria (NCEP-ATP III) for Americans. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to assess the ability of these indexes in screening MetS. Statistical differences among the AUC values of these indexes were compared. The association between the anthropometric indexes and MetS was investigated using weighted multivariable-adjusted logistic regression. RESULTS 560 (35.2%) males and 529 (26.4%) females were diagnosed with MetS. LAP was the strongest predictor of MetS for men (AUC=0.87, 95% CI 0.85-0.89), and also was the strongest for women [AUC=0.85, 95% confidence interval (CI) 0.83-0.86], according to the ROC curve analysis. In men, differences in AUC values between LAP and other anthropometric indicators were also significant (all P<0.001). In women, there was a significant difference in AUC values between LAP and WTI (P<0.001), but differences in AUC values between LAP and TyG, VAI were not significant. CONCLUSION The present study indicated that LAP is a better predictor in the clinical setting for identifying individuals with MetS in the American adult population.
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Affiliation(s)
- Yaling Li
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Rui Zheng
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuting Li
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ruyi Cai
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feihua Ni
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Huiyan Zheng
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ruying Hu
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ting Sun
- Department Health Management Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Ting Sun,
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Ramesh P, Yeo JL, Brady EM, McCann GP. Role of inflammation in diabetic cardiomyopathy. Ther Adv Endocrinol Metab 2022; 13:20420188221083530. [PMID: 35308180 PMCID: PMC8928358 DOI: 10.1177/20420188221083530] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
The prevalence of type 2 diabetes (T2D) has reached a pandemic scale. Systemic chronic inflammation dominates the diabetes pathophysiology and has been implicated as a causal factor for the development of vascular complications. Heart failure (HF) is regarded as the most common cardiovascular complication of T2D and the diabetic diagnosis is an independent risk factor for HF development. Key molecular mechanisms pivotal to the development of diabetic cardiomyopathy include the NF-κB pathway and renin-angiotensin-aldosterone system, in addition to advanced glycation end product accumulation and inflammatory interleukin overexpression. Chronic myocardial inflammation in T2D mediates structural and metabolic changes, including cardiomyocyte apoptosis, impaired calcium handling, myocardial hypertrophy and fibrosis, all of which contribute to the diabetic HF phenotype. Advanced cardiovascular magnetic resonance imaging (CMR) has emerged as a gold standard non-invasive tool to delineate myocardial structural and functional changes. This review explores the role of chronic inflammation in diabetic cardiomyopathy and the ability of CMR to identify inflammation-mediated myocardial sequelae, such as oedema and diffuse fibrosis.
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Affiliation(s)
- Pranav Ramesh
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
| | | | - Emer M. Brady
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
| | - Gerry P. McCann
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
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Sparks LM, Goodpaster BH, Bergman BC. The Metabolic Significance of Intermuscular Adipose Tissue: Is IMAT a Friend or a Foe to Metabolic Health? Diabetes 2021; 70:2457-2467. [PMID: 34711670 DOI: 10.2337/dbi19-0006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/27/2021] [Indexed: 12/25/2022]
Abstract
Adipose tissues are not homogeneous and show site-specific properties. An elusive and understudied adipose tissue depot, most likely due to its limited accessibility, is the intermuscular adipose tissue (IMAT) depot. Adipose tissue is a pliable organ with the ability to adapt to its physiological context, yet whether that adaptation is harmful or beneficial in the IMAT depot remains to be explored in humans. Potential reasons for IMAT accumulation in humans being deleterious or beneficial include 1) sex and related circulating hormone levels, 2) race and ethnicity, and 3) lifestyle factors (e.g., diet and physical activity level). IMAT quantity per se may not be the driving factor in the etiology of insulin resistance and type 2 diabetes, but rather the quality of the IMAT itself is the true puppeteer. Adipose tissue quality likely influences its secreted factors, which are also likely to influence metabolism of surrounding tissues. The advent of molecular assessments such as transcriptome sequencing (RNAseq), assay for transposase-accessible chromatin using sequencing (ATACseq), and DNA methylation at the single-cell and single-nucleus levels, as well as the potential for ultrasound-guided biopsies specifically for IMAT, will permit more sophisticated investigations of human IMAT and dramatically advance our understanding of this enigmatic adipose tissue.
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Medrano M, Cadenas-Sánchez C, Oses M, Villanueva A, Cabeza R, Idoate F, Sanz A, Rodríguez-Vigil B, Ortega FB, Ruiz JR, Labayen I. Associations of fitness and physical activity with specific abdominal fat depots in children with overweight/obesity. Scand J Med Sci Sports 2021; 32:211-222. [PMID: 34570914 DOI: 10.1111/sms.14065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the relationship between physical fitness and physical activity (PA) with specific abdominal fat depots and their potential implications for cardiometabolic risk and insulin resistance (IR) in children with overweight/obesity. MATERIALS AND METHODS A total of 116 children with overweight/obesity (10.7 ± 1.1 year, 54% girls) participated in the study. Abdominal visceral (VAT), subcutaneous (ASAT), and intermuscular abdominal adipose tissue (IMAAT) were assessed by magnetic resonance imaging. The cardiometabolic risk (MetS) score and the insulin resistance homeostasis model assessment (HOMA-IR) were calculated. Health-related physical fitness components (treadmill test, and 20 m shuttle run, handgrip, standing broad jump and 4 × 10 m tests) were evaluated, and PA was measured (accelerometry). Children were categorized as fit or unfit for each specific fitness test, and as active or inactive. RESULTS Higher VAT, ASAT, and IMAAT were associated with higher MetS score and HOMA-IR (all p < 0.02). A better performance in all fitness tests and total and vigorous PA were strongly associated with lower VAT (all p < 0.04), ASAT (all p < 0.005), and IMAAT (all p < 0.005). Fit or active children had lower VAT, ASAT, and IMAAT (all p < 0.03) than their unfit or inactive counterparts. CONCLUSION These results reinforce the importance of having adequate fitness and PA levels to reduce abdominal fat accumulation in children. Given that VAT, ASAT, and IMAAT are associated with higher risk of developing cardiovascular diseases and type 2 diabetes, the improvement of physical fitness by the promotion of PA should be goals of lifestyle interventions for improving health in children with overweight/obesity.
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Affiliation(s)
- María Medrano
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Cristina Cadenas-Sánchez
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Maddi Oses
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Arantxa Villanueva
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | | | - Aritz Sanz
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain.,Navarrabiomed, Pamplona, Spain
| | - Beatriz Rodríguez-Vigil
- Resonancia Magnética Osatek, Hospital Universitario de Álava Vitoria, Vitoria-Gasteiz, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Jonathan R Ruiz
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Elsanhoury A, Nelki V, Kelle S, Van Linthout S, Tschöpe C. Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction-A Specific HFpEF Phenotype. Front Cardiovasc Med 2021; 8:720690. [PMID: 34604353 PMCID: PMC8484763 DOI: 10.3389/fcvm.2021.720690] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/09/2021] [Indexed: 12/22/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with diverse etiologies and pathophysiological factors. Obesity and type 2 diabetes mellitus (T2DM), conditions that coexist frequently, induce a cluster of metabolic and non-metabolic signaling derangements which are in favor to induce inflammation, fibrosis, myocyte stiffness, all hallmarks of HFpEF. In contrast to other HFpEF risk factors, obesity and T2DM are often associated with the generation of enlarged epicardial adipose tissue (EAT). EAT acts as an endocrine tissue that may exacerbate myocardial inflammation and fibrosis via various paracrine and vasocrine signals. In addition, an abnormally large EAT poses mechanical stress on the heart via pericardial restrain. HFpEF patients with enlarged EAT may belong to a unique phenotype that can benefit from specific EAT-targeted interventions, including life-style modifications and pharmacologically via statins and fat modifying anti-diabetics drugs; like metformin, sodium-glucose cotransporter 2 inhibitors, or glucagon-like peptide-1 receptor agonists, respectively.
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Affiliation(s)
- Ahmed Elsanhoury
- Berlin Institute of Health at Charite (BIH), Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Vivian Nelki
- Department of Cardiology, Campus Virchow Klinikum (CVK), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastian Kelle
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Sophie Van Linthout
- Berlin Institute of Health at Charite (BIH), Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Carsten Tschöpe
- Berlin Institute of Health at Charite (BIH), Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Department of Cardiology, Campus Virchow Klinikum (CVK), Charité Universitätsmedizin Berlin, Berlin, Germany
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35
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Khalafi M, Malandish A, Rosenkranz SK, Ravasi AA. Effect of resistance training with and without caloric restriction on visceral fat: A systemic review and meta-analysis. Obes Rev 2021; 22:e13275. [PMID: 33998135 DOI: 10.1111/obr.13275] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/05/2021] [Indexed: 12/29/2022]
Abstract
We performed a systematic review and meta-analysis to investigate the effect of resistance training (RT) with and without caloric restriction (CR) on visceral fat (VF). PubMed and Scopus were searched to identify original articles published through December 2020. Standardized mean differences and 95% confidence intervals (95% CIs) were determined, and separate analyses were conducted for RT versus control, and RT plus CR versus CR only. Thirty-four studies including 38 intervention arms and involving 2285 were included in the meta-analysis. RT effectively reduced VF [-24 (95% CI -0.34 to -0.13), p < 0.001; I2 = 4.17%, p = 0.40; 24 intervention arms] when compared with control. Based on subgroup analyses, reduction in VF was significant for individual with (p = 0.04) and without (p < 0.001) obesity as well as across medium-term (p = 0.001) and long-term (p = 0.002) interventions. Reduction in VF was significant for both middle-age (p = 0.03) and elderly (p = 0.001) adults but was not significant for pediatric (p = 0.08) participants. However, RT plus CR did not indicate superiority effect on VF [0.23 95% CI -0.04 to 0.51, p = 0.09; I2 = 58.76%, p = 0.003; 14 intervention arms] when compared with CR only. Our results confirm that RT may be effective for reducing VF, but adding RT with CR was not associated with a greater effect for reducing VF.
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Affiliation(s)
- Mousa Khalafi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Abbas Malandish
- Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, Kansas, USA
| | - Ali A Ravasi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Sengupta P, Tiwari N, Bhatt T, Paul AT. Mechanistically acting anti-obesity compositions/formulations of natural origin: a patent review (2010-2021). Expert Opin Ther Pat 2021; 32:29-46. [PMID: 34236914 DOI: 10.1080/13543776.2021.1954161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Current health trends indicate that the rate of incidence of obesity has risen considerably. According to the World Health Organization (WHO) report 2017, the issue of obesity has grown to an epidemic proportion, with over 4 million people dying every year. Orlistat, a potent pancreatic lipase (PL) inhibitor for long-term treatment of obesity has been recently reported to cause hepatic and renal toxicities. Hence, there is a need to develop newer, safer and efficacious therapeutics that targets obesity and its associated disorders.Areas covered: The present article attempts to review patents on compositions of natural origin that include either combination of two or more lead NPs/whole extract(s)/ mixture of one or more NPs/extracts from various plants and micro-organisms. Patents that were granted during the period 2010 to 2021 have been considered.Expert opinion: The article highlights the recent trends in the rise of the global obesity population. Patents are classified based on the mechanism of action of extracts/NPs. It has been observed that in the years 2013, 2017 and 2019 maximum number of patents from China, South Korea, United States and Japan have been filed for the anti-obesity compositions.
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Affiliation(s)
- Pracheta Sengupta
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Sciences, Pilani (BITS Pilani), Pilani Campus, Rajasthan, India
| | - Niyati Tiwari
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Sciences, Pilani (BITS Pilani), Pilani Campus, Rajasthan, India
| | - Tanya Bhatt
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Atish T Paul
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Sciences, Pilani (BITS Pilani), Pilani Campus, Rajasthan, India
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Association between organ damage and visceral adiposity index in community-dwelling elderly Chinese population: the Northern Shanghai Study. Aging Clin Exp Res 2021; 33:2291-2297. [PMID: 33219935 DOI: 10.1007/s40520-020-01752-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/30/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The visceral adiposity index (VAI) is a newly developing indicator about visceral fat function and insulin resistance. This research aims to assess the association between organ damage and VAI in the community-dwelling elderly Chinese population. METHODS In total, 3363 elderly participants were recruited between June 2014 and August 2019. VAI was used to measure visceral adipose accumulation, and organ damage was measured with standardized methods, including arterial stiffness, lower extremity atherosclerosis, carotid hypertrophy, left ventricular hypertrophy, micro-albuminuria, and chronic kidney disease. RESULTS According to multivariable linear regression analysis, VAI was related to carotid-femoral pulse wave velocity (cf-PWV; β = 0.047, P = 0.024), urine albumin to creatinine ratio (UACR; β = 3.893, P = 0.008), estimated glomerular filtration rate (eGFR; β = - 0.526, P = 0.003) and loge(ankle-to-brachial index) (ABI; β = -0.003, P = 0.024). Using multivariable stepwise logistic regression model, higher VAI was found to be significantly related to cf-PWV > 10 m/s (OR 1.44, [95% CI 1.17-1.78]; Pfor trend < 0.001), and chronic kidney disease (CKD; OR 1.54, [95% CI 1.09-2.20]; Pfor trend = 0.015). CONCLUSIONS Since higher VAI is related to increased risk of arterial stiffness and CKD, it may serve as a useful index for the assessment of arteriosclerosis and CKD in elderly population. TRIAL REGISTRATION NSS, NCT02368938.
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Kumar S, Kant R, Yadav P, Natarajan K, Bahurupi Y, Mishra A. A Community-Based Study on Waist-to-Height Ratio: An Indicator for Systolic Hypertension in a Rural Community of Hilly Region. Cureus 2021; 13:e16014. [PMID: 34336504 PMCID: PMC8320356 DOI: 10.7759/cureus.16014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/05/2022] Open
Abstract
The prevalence of hypertension gradually becomes a serious public health threat as it is a very pertinent risk factor for cardiovascular and cerebrovascular diseases. This study aims to estimate the prevalence of isolated systolic hypertension (ISH) among the hilly region's rural community and identify the indicators of ISH among study participants. A community-based cross-sectional study was conducted among 1220 participants in the rural community of the hilly region. A multistage random sampling technique was applied to recruit the participants. Demographic and anthropometric dimensions were measured to analyze the outcome of the study. The participants' mean age was 44.42 ± 15.54 years, with a majority of 822 female participants (67.40%). The prevalence of ISH was found as 27.45%. A statistically significant positive correlation (p < 0.05) of the waist-to-height ratio (WHtR) and body mass index (BMI) were observed with systolic blood pressure (SBP) in male as well as female participants, whereas BMI and WHtR had no correlation with diastolic blood pressure (DBP). Among female participants, the area under the curve (AUC) for BMI and WHtR was 0.604 (95% confidence interval 0.565-0.643, p-value = 0.020*) and 0.622 (95% confidence interval 0.584-0.660, p-value = 0.020*), respectively. Among male participants, the AUC for BMI and WHtR was 0.574 and 0.592, respectively. Hence, it cannot be considered very satisfactory. The increasing prevalence of ISH in a rural community is also a public health concern. At the preliminary stage, anthropocentric measurements are the primary tool for a family physician while treating the patients. This study concluded that WHtR is a better indicator than BMI for systolic hypertension. Although we have not observed a strong correlation of WHtR with systolic hypertension, it is required to perform future research to support this study's evidence.
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Affiliation(s)
- Santosh Kumar
- Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ravi Kant
- General Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.,College of Nursing, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Poonam Yadav
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Kavitha Natarajan
- Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Yogesh Bahurupi
- Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ashutosh Mishra
- Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Huang Z, Lu X, Huang L, Zhang C, Veldhuis JD, Cowley MA, Chen C. Stimulation of endogenous pulsatile growth hormone secretion by activation of growth hormone secretagogue receptor reduces the fat accumulation and improves the insulin sensitivity in obese mice. FASEB J 2021; 35:e21269. [PMID: 33368660 DOI: 10.1096/fj.202001924rr] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022]
Abstract
Obese individuals often show low growth hormone (GH) secretion, which leads to reduced lipid mobilization and further fat accumulation. Pharmacological approaches to increase GH levels in obese individuals by GH injection or GH-releasing hormone receptor agonist showed promising effects on fat reduction. However, side effects on glucose metabolism and the heavy costs on making large peptides hindered their clinical application. Here, we tested whether stimulation of endogenous GH secretion by a synthetic GH secretagogue receptor (GHSR) agonist, hexarelin, improved the metabolism in a hyperphagic obese mouse model. Male melanocortin 4 receptor knockout mice (MC4RKO) were pair-fed and received continuous hexarelin (10.56 μg/day) or vehicle infusion by an osmotic pump for 3-4 weeks. Hexarelin treatment significantly increased the pulsatile GH secretion without detectable alteration on basal GH secretion in MC4RKO mice. The treated mice showed increased lipolysis and lipid oxidation in the adipose tissue, and reduced de novo lipogenesis in the liver, leading to reduced visceral fat mass, reduced triglyceride content in liver, and unchanged circulating free fatty acid levels. Importantly, hexarelin treatment improved the whole-body insulin sensitivity but did not alter glucose tolerance, insulin levels, or insulin-like growth factor 1 (IGF-1) levels. The metabolic effects of hexarelin were likely through the direct action of GH, as indicated by the increased expression level of genes involved in GH signaling pathways in visceral adipose tissues and liver. In conclusion, hexarelin treatment stimulated the pulsatile GH secretion and reduced the fat accumulation in visceral depots and liver in obese MC4RKO mice with improved insulin sensitivity without altered levels of insulin or IGF-1. It provides evidence for managing obesity by enhancing pulsatile GH secretion through activation of GHSR in the pituitary gland.
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Affiliation(s)
- Zhengxiang Huang
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Xuehan Lu
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Lili Huang
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Chunhong Zhang
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Johannes D Veldhuis
- Department of Medicine, Endocrine Research Unit, Mayo School of Graduate Medical Education, Clinical Translational Science Center, Mayo Clinic, Rochester, MN, USA
| | - Michael A Cowley
- Department of Physiology, Monash University, Melbourne, VIC, Australia
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD, Australia
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Ohira M, Yokoo H, Ogawa K, Fukai M, Kamiyama T, Sakamoto N, Taketomi A. Serum fatty acid-binding protein 5 is a significant factor in hepatocellular carcinoma progression independent of tissue expression level. Carcinogenesis 2021; 42:794-803. [PMID: 33754641 DOI: 10.1093/carcin/bgab025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 02/05/2023] Open
Abstract
Fatty acid-binding protein 5 (FABP5) is highly expressed in hepatocellular carcinoma (HCC) tissues and is related to HCC progression. In this study, we analyzed the potential of serum FABP5 (sFABP5) as a tumor marker in HCC and its clinical significance in HCC progression. We compared the sFABP5 concentration in patients with HCC (HCC group) with that of patients with hepatitis without HCC (hepatitis group). Moreover, we measured the FABP5 expression levels in resected HCC tissues (tFABP5) and analyzed their relationship with sFABP5. We also performed cell-based assays using FABP5 knockout and overexpressing HCC cell lines to analyze the effect of extrinsic FABP5 (exFABP5) on HCC cells. We showed that sFABP5 was not a useful tumor marker for HCC, as HCC and sFABP5 were not correlated. However, sFABP5 and tFABP5 significantly correlated with survival after surgery for HCC, while sFABP5 and tFABP5 were independent of each other. In cell-based assays, exFABP5 was taken up by HCC cell lines and positively affected cell survival under glucose-depleted conditions by complementing the endogenous FABP5 function. In conclusion, sFABP5 had a significant impact on HCC progression irrespective of tFABP5 by augmenting cell viability under glucose-depleted conditions. As tFABP5 and sFABP5 are important factors that are independent of each other in HCC progression, both of them should be considered independently in improving the prognosis of patients with HCC.
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Affiliation(s)
- Masafumi Ohira
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideki Yokoo
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Koji Ogawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Moto Fukai
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiya Kamiyama
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Teklu M, Zhou W, Kapoor P, Patel N, Dey AK, Sorokin AV, Manyak GA, Teague HL, Erb-Alvarez JA, Sajja A, Abdelrahman KM, Reddy AS, Uceda DE, Lateef SS, Shanbhag SM, Scott C, Prakash N, Svirydava M, Parel P, Rodante JA, Keel A, Siegel EL, Chen MY, Bluemke DA, Playford MP, Gelfand JM, Mehta NN. Metabolic syndrome and its factors are associated with noncalcified coronary burden in psoriasis: An observational cohort study. J Am Acad Dermatol 2021; 84:1329-1338. [PMID: 33383084 DOI: 10.1016/j.jaad.2020.12.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis is associated with a heightened risk of cardiovascular disease and higher prevalence of metabolic syndrome. OBJECTIVE Investigate the effect of metabolic syndrome and its factors on early coronary artery disease assessed as noncalcified coronary burden by coronary computed tomography angiography in psoriasis. METHODS This cross-sectional study consisted of 260 participants with psoriasis and coronary computed tomography angiography characterization. Metabolic syndrome was defined according to the harmonized International Diabetes Federation criteria. RESULTS Of the 260 participants, 80 had metabolic syndrome (31%). The metabolic syndrome group had a higher burden of cardiometabolic disease, systemic inflammation, noncalcified coronary burden, and high-risk coronary plaque. After adjusting for Framingham risk score, lipid-lowering therapy, and biologic use, metabolic syndrome (β = .31; P < .001) and its individual factors of waist circumference (β = .33; P < .001), triglyceride levels (β = .17; P = .005), blood pressure (β = .18; P = .005), and fasting glucose (β = .17; P = .009) were significantly associated with noncalcified coronary burden. After adjusting for all other metabolic syndrome factors, blood pressure and waist circumference remained significantly associated with noncalcified coronary burden. LIMITATIONS Observational nature with limited ability to control for confounders. CONCLUSIONS In psoriasis, individuals with metabolic syndrome had more cardiovascular disease risk factors, systemic inflammation, and noncalcified coronary burden. Efforts to increase metabolic syndrome awareness in psoriasis should be undertaken to reduce the heightened cardiovascular disease risk.
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Affiliation(s)
- Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Wunan Zhou
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Promita Kapoor
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Nidhi Patel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amit K Dey
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alexander V Sorokin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Grigory A Manyak
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Julie A Erb-Alvarez
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aparna Sajja
- Department of Internal Medicine, Johns Hopkins University Medical Center, Baltimore, Maryland
| | - Khaled M Abdelrahman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aarthi S Reddy
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Domingo E Uceda
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sundus S Lateef
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sujata M Shanbhag
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Colin Scott
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Nina Prakash
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Maryia Svirydava
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Philip Parel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Justin A Rodante
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Andrew Keel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Evan L Siegel
- Department of Rheumatology, Arthritis and Rheumatism Associates, Rockville, Maryland
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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42
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Kim JY, Jeon JY. Role of exercise on insulin sensitivity and beta-cell function: is exercise sufficient for the prevention of youth-onset type 2 diabetes? Ann Pediatr Endocrinol Metab 2020; 25:208-216. [PMID: 33401879 PMCID: PMC7788350 DOI: 10.6065/apem.2040140.070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/19/2020] [Indexed: 12/16/2022] Open
Abstract
Parallel with the current pediatric obesity epidemic, the escalating rates of youthonset type 2 diabetes mellitus (T2DM) have become a major public health burden. Although lifestyle modification can be the first-line prevention for T2DM in youths, there is a lack of evidence to establish optimal specific exercise strategies for obese youths at high risk for T2DM. The purpose of this narrative review is to summarize the potential impact of exercise on 2 key pathophysiological risk factors for T2DM, insulin sensitivity and β-cell function, among obese youths. The studies cited are grouped by use of metabolic tests, i.e., direct and indirect measures of insulin sensitivity and β-cell function. In general, there are an increasing number of studies that demonstrate positive effects of aerobic exercise, resistance exercise, and the 2 combined on insulin sensitivity. However, a lack of evidence exists for the effect of any exercise modality on β-cell functional improvement. We also suggest a future direction for research into exercise medical prevention of youth-onset T2DM. These suggestions focus on the effects of exercise modalities on emerging biomarkers of T2DM risk.
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Affiliation(s)
- Joon Young Kim
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Justin Y. Jeon
- Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS Yonsei University, Seoul, Korea,Address for correspondence: Justin Y. Jeon, PhD Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2123-6197 E-mail:
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43
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The Protective Role of Hydrogen Sulfide Against Obesity-Associated Cellular Stress in Blood Glucose Regulation. Antioxidants (Basel) 2020; 9:antiox9111038. [PMID: 33114185 PMCID: PMC7690771 DOI: 10.3390/antiox9111038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022] Open
Abstract
Circulating palmitic acid (PA) is increased in obesity and causes metabolic stress, leading to diabetes. This includes the impairment of the glucoregulatory hormone glucagon-like peptide-1 (GLP-1) secreted from intestinal L-cells. Recently, the anti-inflammatory gasotransmitter hydrogen sulfide (H2S) has been implicated in the enhancement of GLP-1 secretion. We hypothesized that H2S can reduce the oxidative stress caused by palmitate and play a protective role in L-cell function. This study was conducted on both human and mouse L-cells and a mouse model of Western diet (WD)-induced obesity. PA-induced L-cell stress was assessed using DCF-DA. H2S was delivered using the donor GYY4137. C57BL/6 mice were fed either chow diet or PA-enriched WD for 20 weeks with ongoing measurements of glycemia and GLP-1 secretion. In both L-cell models, we demonstrated that PA caused an increase in reactive oxygen species (ROS). This ROS induction was partially blocked by the H2S administration. In mice, the WD elevated body weight in both sexes and elevated fasting blood glucose and lipid peroxidation in males. Additionally, a single GYY4137 injection improved oral glucose tolerance in WD-fed male mice and also enhanced glucose-stimulated GLP-1 release. To conclude, H2S reduces oxidative stress in GLP-1 cells and can improve glucose clearance in mice.
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Usui C, Kawakami R, Tanisawa K, Ito T, Tabata H, Iizuka S, Kawamura T, Midorikawa T, Sawada SS, Torii S, Sakamoto S, Suzuki K, Ishii K, Oka K, Muraoka I, Higuchi M. Visceral fat and cardiorespiratory fitness with prevalence of pre-diabetes/diabetes mellitus among middle-aged and elderly Japanese people: WASEDA'S Health Study. PLoS One 2020; 15:e0241018. [PMID: 33079960 PMCID: PMC7575118 DOI: 10.1371/journal.pone.0241018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/06/2020] [Indexed: 12/29/2022] Open
Abstract
The relationships between cardiorespiratory fitness (CRF) measurements not confounded by adiposity and the prevalence of pre-diabetes mellitus (pre-DM) and diabetes mellitus (DM) are not well known. Thus, we aimed to investigate the associations of visceral fat (VF) and CRF with the prevalence of pre-DM/DM among Japanese adults. The study included 970 individuals (327 women and 643 men) who were 40-87 years old and had complete health examinations, abdominal fat area, and fitness data from WASEDA'S Health Study during 2015-2018. The VF area was measured using magnetic resonance imaging. CRF was measured using a cycle ergometer and was defined as VO2peak divided by fat free mass. The pre-DM/DM was identified based on the questionnaire and fasting blood tests. The odds ratios (ORs) and 95% confidence intervals (CIs) for prevalence of pre-DM/DM were calculated. Seventy-three participants had pre-DM and 48 participants had DM. Compared to the low VF group, the high VF group had a higher prevalence of pre-DM/DM (OR: 1.87, 95% CI: 1.18-2.96), although no significant relationship was observed between CRF and pre-DM/DM prevalence (P for trend = 0.239). The sub-group analyses also revealed no significant relationship between CRF and pre-DM/DM prevalence in the low VF group (P for trend = 0.979), although CRF values were inversely related to the prevalence of pre-DM/DM in the high VF group (P for trend = 0.024). Although CRF was not independently related to the prevalence of pre-DM/DM after adjusting for adiposity, higher VF values were related to a higher prevalence of pre-DM/DM. In addition, CRF levels were inversely associated with the prevalence of pre-DM/DM only among high VF individuals.
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Affiliation(s)
- Chiyoko Usui
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- * E-mail:
| | - Ryoko Kawakami
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Tomoko Ito
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | - Hiroki Tabata
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satoshi Iizuka
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
- Department of Sport Sciences, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Takuji Kawamura
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Taishi Midorikawa
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
- College of Health and Welfare, J. F. Oberlin University, Tokyo, Japan
| | | | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Isao Muraoka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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O'Neill BJ. Effect of low-carbohydrate diets on cardiometabolic risk, insulin resistance, and metabolic syndrome. Curr Opin Endocrinol Diabetes Obes 2020; 27:301-307. [PMID: 32773574 DOI: 10.1097/med.0000000000000569] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW An obesity epidemic has resulted in increasing prevalence of insulin resistance, hyperinsulinemia, metabolic syndrome (MetS), and cardiovascular disease (CVD). The Diet-Heart Hypothesis posited that dietary fat is the culprit. Yet dietary fat reduction has contributed to the problem, not resolved it. The role of hyperinsulinemia, the genesis of its atherogenic dyslipidemia and systemic inflammation in CVD and its reversal is reviewed. RECENT FINDINGS Overnutrition leads to weight gain and carbohydrate intolerance creating a vicious cycle of insulin resistance/hyperinsulinemia inhibiting fat utilization and encouraging fat storage leading to an atherogenic dyslipidemia characterized by hypertriglyceridemia, low HDL, and small dense LDL. The carbohydrate-insulin model better accounts for the pathogenesis of obesity, MetS, and ultimately type 2 diabetes (T2DM) and CVD. Ketogenic Diets reduce visceral obesity, increase insulin sensitivity, reverse the atherogenic dyslipidemia and the inflammatory biomarkers of overnutrition. Recent trials show very high adherence to ketogenic diet for up to 2 years in individuals with T2DM, reversing their metabolic, inflammatory and dysglycemic biomarkers as well as the 10-year estimated atherosclerotic risk. Diabetes reversal occurred in over 50% and complete remission in nearly 8%. SUMMARY Therapeutic carbohydrate-restricted can prevent or reverse the components of MetS and T2DM.
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Affiliation(s)
- Blair J O'Neill
- Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
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46
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Frasca D, Blomberg BB. Adipose tissue, immune aging, and cellular senescence. Semin Immunopathol 2020; 42:573-587. [PMID: 32785750 DOI: 10.1007/s00281-020-00812-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022]
Abstract
Obesity represents a serious health problem as it is rapidly increasing worldwide. Obesity is associated with reduced healthspan and lifespan, decreased responses to infections and vaccination, and increased frequency of inflammatory conditions typical of old age. Obesity is characterized by increased fat mass and remodeling of the adipose tissue (AT). In this review, we summarize published data on the different types of AT present in mice and humans, and their roles as fat storage as well as endocrine and immune tissues. We review the age-induced changes, including those in the distribution of fat in the body, in abundance and function of adipocytes and their precursors, and in the infiltration of immune cells from the peripheral blood. We also show that cells with a senescent-associated secretory phenotype accumulate in the AT of mice and humans with age, where they secrete several factors involved in the establishment and maintenance of local inflammation, oxidative stress, cell death, tissue remodeling, and infiltration of pro-inflammatory immune cells. Not only adipocytes and pre-adipocytes but also immune cells show a senescent phenotype in the AT. With the increase in human lifespan, it is crucial to identify strategies of intervention and target senescent cells in the AT to reduce local and systemic inflammation and the development of age-associated diseases. Several studies have indeed shown that senescent cells can be effectively targeted in the AT by selectively removing them or by inhibiting the pathways that lead to the secretion of pro-inflammatory factors.
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Affiliation(s)
- Daniela Frasca
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA. .,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Bonnie B Blomberg
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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47
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Glastonbury CA, Pulit SL, Honecker J, Censin JC, Laber S, Yaghootkar H, Rahmioglu N, Pastel E, Kos K, Pitt A, Hudson M, Nellåker C, Beer NL, Hauner H, Becker CM, Zondervan KT, Frayling TM, Claussnitzer M, Lindgren CM. Machine Learning based histology phenotyping to investigate the epidemiologic and genetic basis of adipocyte morphology and cardiometabolic traits. PLoS Comput Biol 2020; 16:e1008044. [PMID: 32797044 PMCID: PMC7449405 DOI: 10.1371/journal.pcbi.1008044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 08/26/2020] [Accepted: 06/11/2020] [Indexed: 12/29/2022] Open
Abstract
Genetic studies have recently highlighted the importance of fat distribution, as well as overall adiposity, in the pathogenesis of obesity-associated diseases. Using a large study (n = 1,288) from 4 independent cohorts, we aimed to investigate the relationship between mean adipocyte area and obesity-related traits, and identify genetic factors associated with adipocyte cell size. To perform the first large-scale study of automatic adipocyte phenotyping using both histological and genetic data, we developed a deep learning-based method, the Adipocyte U-Net, to rapidly derive mean adipocyte area estimates from histology images. We validate our method using three state-of-the-art approaches; CellProfiler, Adiposoft and floating adipocytes fractions, all run blindly on two external cohorts. We observe high concordance between our method and the state-of-the-art approaches (Adipocyte U-net vs. CellProfiler: R2visceral = 0.94, P < 2.2 × 10-16, R2subcutaneous = 0.91, P < 2.2 × 10-16), and faster run times (10,000 images: 6mins vs 3.5hrs). We applied the Adipocyte U-Net to 4 cohorts with histology, genetic, and phenotypic data (total N = 820). After meta-analysis, we found that mean adipocyte area positively correlated with body mass index (BMI) (Psubq = 8.13 × 10-69, βsubq = 0.45; Pvisc = 2.5 × 10-55, βvisc = 0.49; average R2 across cohorts = 0.49) and that adipocytes in subcutaneous depots are larger than their visceral counterparts (Pmeta = 9.8 × 10-7). Lastly, we performed the largest GWAS and subsequent meta-analysis of mean adipocyte area and intra-individual adipocyte variation (N = 820). Despite having twice the number of samples than any similar study, we found no genome-wide significant associations, suggesting that larger sample sizes and a homogenous collection of adipose tissue are likely needed to identify robust genetic associations.
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Affiliation(s)
- Craig A. Glastonbury
- Big Data Institute, University of Oxford, Oxford, United Kingdom
- BenevolentAI, London, United Kingdom
| | - Sara L. Pulit
- Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Julius Honecker
- Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Jenny C. Censin
- Big Data Institute, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics (WCHG), Oxford, United Kingdom
| | - Samantha Laber
- Big Data Institute, University of Oxford, Oxford, United Kingdom
- Broad Institute of MIT and Harvard, Cambridge Massachusetts, United States of America
| | - Hanieh Yaghootkar
- Genetics of Complex Traits, University of Exeter Medical School, Royal Devon & Exeter Hospital, Exeter, United Kingdom
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Nilufer Rahmioglu
- Wellcome Centre for Human Genetics (WCHG), Oxford, United Kingdom
- Endometriosis CaRe Centre Oxford, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Emilie Pastel
- Genetics of Complex Traits, University of Exeter Medical School, Royal Devon & Exeter Hospital, Exeter, United Kingdom
| | - Katerina Kos
- Genetics of Complex Traits, University of Exeter Medical School, Royal Devon & Exeter Hospital, Exeter, United Kingdom
| | - Andrew Pitt
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, University of Exeter and Royal Devon and Exeter NHS Foundation Trust Exeter, United Kingdom
| | - Michelle Hudson
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, University of Exeter and Royal Devon and Exeter NHS Foundation Trust Exeter, United Kingdom
| | - Christoffer Nellåker
- Big Data Institute, University of Oxford, Oxford, United Kingdom
- Endometriosis CaRe Centre Oxford, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Nicola L. Beer
- Novo Nordisk Research Centre Oxford (NNRCO), Oxford, United Kingdom
| | - Hans Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich
- German Center of Diabetes Research, Helmholtz Center Munich, Neuherberg, Germany
| | - Christian M. Becker
- Endometriosis CaRe Centre Oxford, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Krina T. Zondervan
- Wellcome Centre for Human Genetics (WCHG), Oxford, United Kingdom
- Endometriosis CaRe Centre Oxford, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Timothy M. Frayling
- Genetics of Complex Traits, University of Exeter Medical School, Royal Devon & Exeter Hospital, Exeter, United Kingdom
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, University of Exeter and Royal Devon and Exeter NHS Foundation Trust Exeter, United Kingdom
| | - Melina Claussnitzer
- Broad Institute of MIT and Harvard, Cambridge Massachusetts, United States of America
- University of Hohenheim, Stuttgart, Germany
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Cecilia M. Lindgren
- Big Data Institute, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics (WCHG), Oxford, United Kingdom
- Broad Institute of MIT and Harvard, Cambridge Massachusetts, United States of America
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Comparison of 7-site skinfold measurement and dual-energy X-ray absorptiometry for estimating body fat percentage and regional adiposity in Taiwanese diabetic patients. PLoS One 2020; 15:e0236323. [PMID: 32706814 PMCID: PMC7380604 DOI: 10.1371/journal.pone.0236323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/02/2020] [Indexed: 02/08/2023] Open
Abstract
Obesity and regional adiposity are important risk factors for cardiometabolic disorders. The aim of this study is to compare 7-site skinfold (SF) measurement to dual-energy x-ray absorptiometry (DXA) as the reference method for estimating body fat percentage (BF%) and regional adiposity in diabetic outpatients. A total of 59 diabetic patients (36 females and 23 males) aged 28.5–78 years (median 67.7 years) with BMI 18.8–40.6 kg/m2 (median: 25.5 kg/m2) were enrolled. 7-site skinfold measurement and DXA were performed at the same visit day and biochemistry data were collected. Our results demonstrate the BF% calculated via Jackson & Pollock 7-site skinfold equation presents a strong correlation (r = 0.672, p < 0.001 in females; r = 0.885, p < 0.001 in males) with that measured by DXA, but the means of BF% between these two methods are significantly different in both sexes (paired t-test, p < 0.001). The Bland-Altman analysis showed the mean differences (DXA-SF) of BF% were positive for female (8.74%) and male (7.22%), suggesting Jackson & Pollock 7-site skinfold equation tends to underestimate the BF%. Besides, regional SF thicknesses of 7-site skinfold measurement were significantly correlated with the matched regional adiposity quantified by DXA. Furthermore, truncal and android SF thicknesses were notably positively correlated with several cardiometabolic risk factors in gender-specific manner. Our data indicate the 7-site skinfold measurement is not an interchangeable method for precisely measuring BF%, but might be practical for evaluating the cardiometabolic risks in Taiwanese diabetic outpatients.
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Antonio-Villa NE, Bello-Chavolla OY, Vargas-Vázquez A, Mehta R, Aguilar-Salinas CA. The combination of insulin resistance and visceral adipose tissue estimation improves the performance of metabolic syndrome as a predictor of type 2 diabetes. Diabet Med 2020; 37:1192-1201. [PMID: 32061103 DOI: 10.1111/dme.14274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 12/16/2022]
Abstract
AIMS To assess the performance of metabolic syndrome as a predictor of type 2 diabetes in a model that also includes both a measure of insulin resistance and a metabolic score for visceral fat, and to propose a novel metabolic syndrome definition. METHODS In a prospective Metabolic Syndrome Cohort (n=6143), we evaluated improvements in type 2 diabetes risk prediction using International Diabetes Federation-defined and Adult Treatment Panel III-defined metabolic syndrome, after inclusion in the model of updated homeostatic model assessment of insulin resistance and a metabolic score for visceral fat. We also developed a modified metabolic syndrome construct, 'MS-METS', which used the metabolic score for visceral fat instead of waist circumference to evaluate improved predictive performance for risk of developing type 2 diabetes. RESULTS Participants who had metabolic syndrome as defined by both the Adult Treatment Panel III and the International Diabetes Federation criteria had a higher risk of type 2 diabetes compared to participants who did not meet these criteria. Addition of updated homeostatic model assessment of insulin resistance and metabolic score for visceral fat to both metabolic syndrome definitions increased predictive performance for type 2 diabetes risk. Homeostatic model assessment of insulin resistance was the only additional predictor of type 2 diabetes in participants without metabolic syndrome. Conversely, in participants with metabolic syndrome, the use of the metabolic score for visceral fat was the stronger added predictor for type 2 diabetes. When evaluating participants using the MS-METS definition we observed the largest improvement in predictive ability for type 2 diabetes risk and a significant reduction in risk overestimation compared to evaluation using metabolic syndrome defined according to the International Diabetes Federation and Adult Treatment Panel III criteria alone. CONCLUSION Inclusion of updated homeostatic model assessment of insulin resistance and metabolic score for visceral fat increases performance of metabolic syndrome in prediction of type 2 diabetes. Assessment of insulin resistance could be more useful than conventional metabolic syndrome and assessment of visceral adipose tissue could be more useful in people with metabolic syndrome. Metabolic syndrome as defined using our modified MS-METS construct improved the accuracy of type 2 diabetes prediction.
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Affiliation(s)
- N E Antonio-Villa
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- MD/PhD (PECEM) Program, Faculty of Medicine, Universidad Nacional Autonoma de México, Tlalpan, Mexico
| | - O Y Bello-Chavolla
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Department of Physiology, Faculty of Medicine, Universidad Nacional Autonoma de México, Tlalpan, Mexico
- Research Division, Instituto Nacional de Geriatría, Tlalpan, Mexico
| | - A Vargas-Vázquez
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- MD/PhD (PECEM) Program, Faculty of Medicine, Universidad Nacional Autonoma de México, Tlalpan, Mexico
| | - R Mehta
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Department of Endocrinolgy and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
| | - C A Aguilar-Salinas
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Department of Endocrinolgy and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Tlalpan, Mexico
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Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. The visceral adiposity index is a predictor of incident nonalcoholic fatty liver disease: A population-based longitudinal study. Clin Res Hepatol Gastroenterol 2020; 44:375-383. [PMID: 32434704 DOI: 10.1016/j.clinre.2019.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 03/30/2019] [Accepted: 04/05/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Visceral adiposity index (VAI), calculated with body mass index, high-density lipoprotein cholesterol, triglyceride and waist circumference, has been proposed as a marker of visceral fat accumulation and dysfunction. METHODS The impact of VAI on incident nonalcoholic fatty liver disease (NAFLD) in a historical cohort study of 8399 (3773 men and 4626 women) participants. NAFLD was defined as having fatty liver diagnosed by abdominal ultrasonography. We divided the participants into two groups according to sex and into quartiles according to VAI (Q1-4). We calculated VAI using the formulas. Men: VAI = [waist circumference (WC)/39.68 + (1.88 × body mass index [BMI])] × [triglycerides (TG)/1.03] × [1.31/high-density lipoprotein cholesterol (HDL)]; women: VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL). We performed Cox proportional hazard models, adjusting for age, alanine aminotransferase, fasting plasma glucose, systolic blood pressure, alcohol consumption, smoking status and exercise. RESULTS During the median 4.5-year follow-up for men and 4.9-year follow-up for women, 1078 participants (737 men and 341 women) developed NAFLD. The 4000 days cumulative incidence rate of NAFLD for men and women were 7.5% and 2.2% in Q1, 14.5% and 4.0% in Q2, 22.3% and 6.7% in Q3 and 33.8% and 16.7% in Q4. The hazard ratios of incident NAFLD in Q4 (VAI: men, > 1.13; women, > 0.83) were 3.69 (95% confidence interval 2.84-4.86, P < 0.001) in men and 4.93 (3.28-7.73, P < 0.001) in women, compared to Q1 (VAI: men, < 0.44; women, < 0.36). CONCLUSIONS The visceral adiposity index can be a predictor of incident NAFLD.
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Affiliation(s)
- Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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